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:
99202-1377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-309-3087
Provider Business Practice Location Address Fax Number:
509-835-4272
Provider Enumeration Date:
02/04/2014