Provider First Line Business Practice Location Address:
2930 E 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:
99202-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-2906
Provider Business Practice Location Address Fax Number:
509-535-2907
Provider Enumeration Date:
10/09/2006