Provider First Line Business Practice Location Address:
1027 FAIR STREET STE D
Provider Second Line Business Practice Location Address:
FAMILY CHIROPRACTIC
Provider Business Practice Location Address City Name:
PRESCOTT
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86305-1897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-445-2652
Provider Business Practice Location Address Fax Number:
928-445-0387
Provider Enumeration Date:
06/29/2007