Provider First Line Business Practice Location Address:
6615 COMANCHE ST
Provider Second Line Business Practice Location Address:
KANIKSU HEALTH SERVICES
Provider Business Practice Location Address City Name:
BONNERS FERRY
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-267-1718
Provider Business Practice Location Address Fax Number:
208-267-9197
Provider Enumeration Date:
07/07/2009