Provider First Line Business Practice Location Address:
1717 W FRANCIS AVE 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:
99205-6858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-230-3914
Provider Business Practice Location Address Fax Number:
509-464-6959
Provider Enumeration Date:
10/11/2025