Provider First Line Business Practice Location Address:
628 S COWLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-3227
Provider Business Practice Location Address Fax Number:
509-459-3920
Provider Enumeration Date:
07/22/2006