Provider First Line Business Practice Location Address:
302 E PACIFIC 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:
99202-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-557-0450
Provider Business Practice Location Address Fax Number:
509-757-8981
Provider Enumeration Date:
10/29/2019