Provider First Line Business Practice Location Address:
1414 S CEDAR 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:
99203-1040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-298-8895
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2023