Provider First Line Business Practice Location Address:
4117 S LEE 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:
99203-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-471-3217
Provider Business Practice Location Address Fax Number:
509-270-3214
Provider Enumeration Date:
11/06/2024