Provider First Line Business Practice Location Address:
601 W RIVERSIDE AVE STE 140B
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:
99201-0621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-2111
Provider Business Practice Location Address Fax Number:
509-624-9500
Provider Enumeration Date:
08/10/2021