Provider First Line Business Practice Location Address:
12525 E. MISSION AVE
Provider Second Line Business Practice Location Address:
#104
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-1079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-1500
Provider Business Practice Location Address Fax Number:
509-928-8006
Provider Enumeration Date:
04/14/2009