Provider First Line Business Practice Location Address:
4106 N COOK ST
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:
99207-5892
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-354-5860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2021