Provider First Line Business Practice Location Address:
100 N HOWARD ST STE R
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:
99201-0508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-761-1339
Provider Business Practice Location Address Fax Number:
206-589-9128
Provider Enumeration Date:
03/15/2019