Provider First Line Business Practice Location Address:
504 E SPRAGUE AVE
Provider Second Line Business Practice Location Address:
E.
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-4651
Provider Business Practice Location Address Fax Number:
509-685-0642
Provider Enumeration Date:
07/18/2024