Provider First Line Business Practice Location Address:
916 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:
99202-1924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-487-3838
Provider Business Practice Location Address Fax Number:
509-482-9097
Provider Enumeration Date:
11/15/2011