Provider First Line Business Practice Location Address:
520 S COWLEY ST STE 101
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-1445
Provider Business Practice Location Address Fax Number:
509-455-8955
Provider Enumeration Date:
09/01/2016