Provider First Line Business Practice Location Address:
922 S COWLEY ST
Provider Second Line Business Practice Location Address:
SUITE 6
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:
509-220-3048
Provider Business Practice Location Address Fax Number:
509-279-0286
Provider Enumeration Date:
04/18/2006