Provider First Line Business Practice Location Address:
1722 E SPRAGUE AVE STE 214
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:
99202-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-505-9614
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2019