Provider First Line Business Practice Location Address:
3026 E. 5TH AVE
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-4184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-964-1747
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/07/2025