Provider First Line Business Practice Location Address:
222 W. MISSION AVENUE
Provider Second Line Business Practice Location Address:
SUITE 232
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-402-1569
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2010