Provider First Line Business Practice Location Address:
12 E ROWAN AVE STE L3
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:
99207-1281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-359-8807
Provider Business Practice Location Address Fax Number:
509-293-6506
Provider Enumeration Date:
03/20/2013