Provider First Line Business Practice Location Address:
3115 E MISSION 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:
99202-3628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-362-7420
Provider Business Practice Location Address Fax Number:
888-420-1329
Provider Enumeration Date:
01/03/2011