Provider First Line Business Practice Location Address:
3527 E SPRAGUE AVE STE H
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:
99202-4894
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-368-7556
Provider Business Practice Location Address Fax Number:
509-808-2267
Provider Enumeration Date:
05/28/2025