Provider First Line Business Practice Location Address:
120 W 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:
99201-2358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-4343
Provider Business Practice Location Address Fax Number:
509-329-2280
Provider Enumeration Date:
10/17/2006