Provider First Line Business Practice Location Address:
12623 E SPRAGUE AVE STE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-0764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-505-4035
Provider Business Practice Location Address Fax Number:
509-253-5183
Provider Enumeration Date:
01/22/2025