Provider First Line Business Practice Location Address:
124 E ROWAN
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-484-1600
Provider Business Practice Location Address Fax Number:
509-484-0214
Provider Enumeration Date:
03/28/2006