Provider First Line Business Practice Location Address:
4927 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:
99217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-505-9614
Provider Business Practice Location Address Fax Number:
509-960-5916
Provider Enumeration Date:
06/02/2025