Provider First Line Business Practice Location Address:
59 E QUEEN AVE
Provider Second Line Business Practice Location Address:
SUITE #2B
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-869-8075
Provider Business Practice Location Address Fax Number:
509-876-3013
Provider Enumeration Date:
09/24/2024