Provider First Line Business Practice Location Address:
122 E MAIN ST
Provider Second Line Business Practice Location Address:
AKDHC (MOUNTAIN VIEW FAMILY CLINIC)
Provider Business Practice Location Address City Name:
PAYSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85541-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-474-2888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/31/2007