Provider First Line Business Practice Location Address:
12615 E MISSION AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-1047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-228-1200
Provider Business Practice Location Address Fax Number:
509-252-9300
Provider Enumeration Date:
10/21/2005