Provider First Line Business Practice Location Address:
10258 W HIGHWAY 2 STE 4
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:
99224-5459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-244-9968
Provider Business Practice Location Address Fax Number:
509-244-9914
Provider Enumeration Date:
06/02/2021