Provider First Line Business Practice Location Address:
2224 S PARK 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:
99212-3068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-460-6548
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2024