Provider First Line Business Practice Location Address:
319 S CEDAR ST
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:
99201-7029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-209-7429
Provider Business Practice Location Address Fax Number:
509-340-9942
Provider Enumeration Date:
03/08/2022