Provider First Line Business Practice Location Address:
2308 W 3RD AVE
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:
99201-5810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-1244
Provider Business Practice Location Address Fax Number:
509-624-6240
Provider Enumeration Date:
08/10/2017