Provider First Line Business Practice Location Address:
422 W RIVERSIDE AVE STE 518
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:
99201-0302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-209-3167
Provider Business Practice Location Address Fax Number:
888-212-4015
Provider Enumeration Date:
07/27/2023