Provider First Line Business Practice Location Address:
12509 E MISSION AVE STE 103
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:
99216-1061
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:
Provider Enumeration Date:
10/24/2006