Provider First Line Business Practice Location Address:
1519 W KNOX AVE
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:
99205-4367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-703-8235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/20/2021