Provider First Line Business Mailing Address:
980 W. IRONWOOD DRIVE, SUITE 302
Provider Second Line Business Mailing Address:
LAKESIDE PEDIATRIC AND ADOLESCENT MEDICINE,
Provider Business Mailing Address City Name:
COEUR D ALENE
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83814-9998
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-292-5437
Provider Business Mailing Address Fax Number:
208-292-5441