Provider First Line Business Practice Location Address:
2721 E SPRAGUE 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:
99202-3940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-3038
Provider Business Practice Location Address Fax Number:
509-535-9749
Provider Enumeration Date:
06/20/2022