Provider First Line Business Practice Location Address:
12509 E. MISSION AVE
Provider Second Line Business Practice Location Address:
SUITE #103
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-6400
Provider Business Practice Location Address Fax Number:
509-928-6441
Provider Enumeration Date:
05/22/2017