Provider First Line Business Practice Location Address:
4001 N COOK 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:
99207-5879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-483-3427
Provider Business Practice Location Address Fax Number:
509-482-5064
Provider Enumeration Date:
09/04/2008