Provider First Line Business Practice Location Address:
1724 N COOK ST
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:
99207-5314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-998-4348
Provider Business Practice Location Address Fax Number:
509-534-2062
Provider Enumeration Date:
03/11/2020