Provider First Line Business Practice Location Address:
15425 E. MISSION AVE
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:
99037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-3111
Provider Business Practice Location Address Fax Number:
509-928-7662
Provider Enumeration Date:
03/25/2011