Provider First Line Business Practice Location Address:
8012 E CATALDO AVE APT 61
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:
99212-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-859-8228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/02/2026