Provider First Line Business Practice Location Address:
921 S 8TH AVE STOP 8333
Provider Second Line Business Practice Location Address:
ISU COLLEGE OF PHARMACY
Provider Business Practice Location Address City Name:
POCATELLO
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83209-8333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-589-3784
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2013