Provider First Line Business Practice Location Address:
STAR SPEECH AND OCCUPATIONAL THERAPY
Provider Second Line Business Practice Location Address:
12222 W BRIDGER BAY DR
Provider Business Practice Location Address City Name:
STAR
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-503-6953
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2021