Provider First Line Business Practice Location Address:
JCT. HWY 160 & NAVAJO ROUTE 35 - RED MESA
Provider Second Line Business Practice Location Address:
FOUR CORNERS REGIONAL HEALTH CENTER
Provider Business Practice Location Address City Name:
TEEC NOS POS
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-656-5000
Provider Business Practice Location Address Fax Number:
928-656-5164
Provider Enumeration Date:
10/30/2012