Provider First Line Business Practice Location Address:
112 E 1ST AVE
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:
99202-1541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-601-9205
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/19/2024