Provider First Line Business Practice Location Address:
701 E 3RD 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:
99202-6014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-6092
Provider Business Practice Location Address Fax Number:
509-838-6110
Provider Enumeration Date:
02/12/2019