Provider First Line Business Practice Location Address:
16528 E DESMET CT # 3100
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:
99216-3522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-434-6949
Provider Business Practice Location Address Fax Number:
509-434-6949
Provider Enumeration Date:
10/13/2025