Provider First Line Business Practice Location Address:
455 N 8TH AVE
Provider Second Line Business Practice Location Address:
HOLBROOK HIGH SCHOOL
Provider Business Practice Location Address City Name:
HOLBROOK
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86025-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-524-2815
Provider Business Practice Location Address Fax Number:
928-524-3537
Provider Enumeration Date:
02/11/2010