Provider First Line Business Practice Location Address:
101 N HOWARD 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:
99201-0507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-854-5693
Provider Business Practice Location Address Fax Number:
615-658-4269
Provider Enumeration Date:
02/26/2026