Provider First Line Business Practice Location Address:
8817 E MISSION AVE
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99212-5034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-1400
Provider Business Practice Location Address Fax Number:
509-328-5268
Provider Enumeration Date:
09/03/2009