Provider First Line Business Practice Location Address:
522 W RIVERSIDE AVE STE N
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:
99201-0580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-631-8225
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2023