Provider First Line Business Practice Location Address:
12525 E MISSION
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-9811
Provider Business Practice Location Address Fax Number:
509-924-0640
Provider Enumeration Date:
03/01/2007