Provider First Line Business Practice Location Address:
902 N ADAMS 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:
99260-2002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-477-6383
Provider Business Practice Location Address Fax Number:
509-477-2496
Provider Enumeration Date:
03/19/2025