Provider First Line Business Practice Location Address:
601 S DIVISION ST STE B
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:
99202-1335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-309-2230
Provider Business Practice Location Address Fax Number:
509-309-2739
Provider Enumeration Date:
05/14/2021