Provider First Line Business Practice Location Address:
AUSPEX DIAMOND LLC ST # 2079
Provider Second Line Business Practice Location Address:
9169 W STATE
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-459-9808
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2025