Provider First Line Business Practice Location Address:
12615 E MISSION AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
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:
509-232-3959
Provider Business Practice Location Address Fax Number:
509-343-0154
Provider Enumeration Date:
08/27/2018