Provider First Line Business Practice Location Address:
1411 W. GARLAND SUITE 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-868-4027
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2021