Provider First Line Business Practice Location Address:
PETROGLYPH PATHOLOGY SERVICES LLC
Provider Second Line Business Practice Location Address:
1207B GOLF COURSE RD SE
Provider Business Practice Location Address City Name:
RIO RANCHO
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-924-0209
Provider Business Practice Location Address Fax Number:
505-924-0210
Provider Enumeration Date:
10/31/2006