Provider First Line Business Practice Location Address:
1309 PONDEROSA DRIVE 7B CHIROPRACTIC
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
SANDPOINT
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-597-7863
Provider Business Practice Location Address Fax Number:
208-597-7863
Provider Enumeration Date:
07/07/2006