Provider First Line Business Practice Location Address:
3010 S SOUTHEAST BLVD STE A
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:
99223-3540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-352-3777
Provider Business Practice Location Address Fax Number:
509-343-3717
Provider Enumeration Date:
09/28/2022