Provider First Line Business Practice Location Address:
1003 DIVISION ST
Provider Second Line Business Practice Location Address:
STE 1 ROCKY MOUNTAIN MEDICAL PLLC
Provider Business Practice Location Address City Name:
PRESCOTT
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-777-2425
Provider Business Practice Location Address Fax Number:
928-777-9044
Provider Enumeration Date:
11/08/2006