Provider First Line Business Practice Location Address:
711 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:
99202-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-473-6008
Provider Business Practice Location Address Fax Number:
509-473-6005
Provider Enumeration Date:
12/11/2012