Provider First Line Business Practice Location Address:
3001 S. MT. VERNON ST.
Provider Second Line Business Practice Location Address:
SUITE 201 #1
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-903-8570
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2023