Provider First Line Business Practice Location Address:
7 S HOWARD ST STE 104
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:
99201-3821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-517-7465
Provider Business Practice Location Address Fax Number:
509-641-4625
Provider Enumeration Date:
01/07/2021