Provider First Line Business Practice Location Address:
2921 N CARNAHAN 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:
99217-5124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-290-6647
Provider Business Practice Location Address Fax Number:
205-528-6242
Provider Enumeration Date:
05/08/2023