Provider First Line Business Practice Location Address:
9704 N ARROWHEAD RD
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:
99208-9423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-466-2816
Provider Business Practice Location Address Fax Number:
509-984-4192
Provider Enumeration Date:
02/27/2026