Provider First Line Business Mailing Address:
2719 S KIMBALL AVE
Provider Second Line Business Mailing Address:
P.O. BOX 1022 EMMETT, ID 83617
Provider Business Mailing Address City Name:
CALDWELL
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83605-5623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-459-6557
Provider Business Mailing Address Fax Number:
208-453-8847