Provider First Line Business Practice Location Address:
12209 E. MISSION AVE SUITE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-1580
Provider Business Practice Location Address Fax Number:
509-342-7890
Provider Enumeration Date:
02/20/2014