Provider First Line Business Practice Location Address:
12120 E MISSION AVE STE 2
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:
99206-5378
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-927-0700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2007