Provider First Line Business Practice Location Address:
100 N HOWARD ST STE W
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:
99201-0508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-954-3382
Provider Business Practice Location Address Fax Number:
855-954-4564
Provider Enumeration Date:
03/31/2025