Provider First Line Business Practice Location Address:
10408 W SUNSET HWY STE 3
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:
99224-6002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-418-2799
Provider Business Practice Location Address Fax Number:
883-983-2962
Provider Enumeration Date:
12/27/2019