Provider First Line Business Practice Location Address:
12020 N NEWPORT HWY
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:
99218-1655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-466-3315
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/07/2020