Provider First Line Business Practice Location Address:
3809 N MONROE 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:
99205-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-3795
Provider Business Practice Location Address Fax Number:
509-325-7418
Provider Enumeration Date:
05/15/2018