Provider First Line Business Practice Location Address:
729 S BERNARD ST STE D
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:
99204-2529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-418-9680
Provider Business Practice Location Address Fax Number:
509-245-7110
Provider Enumeration Date:
05/14/2021