Provider First Line Business Practice Location Address:
801 E MEDICAL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POST FALLS
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83854-7298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-773-1559
Provider Business Practice Location Address Fax Number:
208-773-9959
Provider Enumeration Date:
03/31/2015