Provider First Line Business Practice Location Address:
5920 N BRIDGET 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:
99208-7062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-581-3550
Provider Business Practice Location Address Fax Number:
509-232-3309
Provider Enumeration Date:
03/18/2022