Provider First Line Business Practice Location Address:
520 S COWLEY ST
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:
99202-1315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-3703
Provider Business Practice Location Address Fax Number:
509-838-0375
Provider Enumeration Date:
07/16/2006