Provider First Line Business Practice Location Address:
715 S COWLEY ST STE 228
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:
99202-1383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-473-6706
Provider Business Practice Location Address Fax Number:
509-473-6704
Provider Enumeration Date:
09/04/2007