Provider First Line Business Practice Location Address:
101 E MAGNESIUM RD STE 101
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:
99208-5901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-368-9021
Provider Business Practice Location Address Fax Number:
509-474-1796
Provider Enumeration Date:
10/27/2017