Provider First Line Business Practice Location Address:
220 E ROWAN AVE
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-1202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-7866
Provider Business Practice Location Address Fax Number:
509-489-7762
Provider Enumeration Date:
09/28/2007