Provider First Line Business Practice Location Address:
1000 E PARK BLVD IDAHO CENTER FOR REPRODUCTIVE MEDICINE
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
BOISE
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-342-5900
Provider Business Practice Location Address Fax Number:
208-342-2088
Provider Enumeration Date:
01/20/2006