Provider First Line Business Practice Location Address:
13103 E MANSFIELD 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:
99216-1642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-892-2700
Provider Business Practice Location Address Fax Number:
509-892-2740
Provider Enumeration Date:
09/14/2012