Provider First Line Business Practice Location Address:
2523 W LIBERTY AVE
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:
99205-2470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-750-0055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2026