Provider First Line Business Practice Location Address:
504 E 2ND 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:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-822-8552
Provider Business Practice Location Address Fax Number:
509-462-2503
Provider Enumeration Date:
07/09/2021