Provider First Line Business Practice Location Address:
704 S LATAH
Provider Second Line Business Practice Location Address:
THE FRIENDSHIP CLINIC
Provider Business Practice Location Address City Name:
BOISE
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-429-6678
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2007