Provider First Line Business Practice Location Address:
1616 W WELLESLEY AVE STE A
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:
99205-1413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-835-5898
Provider Business Practice Location Address Fax Number:
509-568-0309
Provider Enumeration Date:
09/13/2022