Provider First Line Business Practice Location Address:
826 NORTH MULLAN RD.
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
SPOKANE
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:
509-926-7431
Provider Business Practice Location Address Fax Number:
509-926-1359
Provider Enumeration Date:
10/22/2013