Provider First Line Business Practice Location Address:
398 S. CORBIN RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POST FALLS
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-981-1111
Provider Business Practice Location Address Fax Number:
208-908-0060
Provider Enumeration Date:
02/28/2014