Provider First Line Business Practice Location Address:
231 STUDENT HEALTH & COUNSELING BLDG
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REXBURG
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83460-2020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-496-9370
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2013