Provider First Line Business Practice Location Address:
3001 S MOUNT VERNON ST STE 201
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:
99223-4755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-828-0695
Provider Business Practice Location Address Fax Number:
509-272-7700
Provider Enumeration Date:
02/11/2020