Provider First Line Business Practice Location Address:
10005 N HUNTINGTON RD
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:
99218-2354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-703-7997
Provider Business Practice Location Address Fax Number:
509-703-7640
Provider Enumeration Date:
08/13/2024