Provider First Line Business Practice Location Address:
922 S COWLEY ST STE 6
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:
99202-1263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-2621
Provider Business Practice Location Address Fax Number:
509-624-6396
Provider Enumeration Date:
11/13/2007