Provider First Line Business Practice Location Address:
565 N CHERRY AVE
Provider Second Line Business Practice Location Address:
LSFF ATHLETIC TRAINING ROOM
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-699-0148
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2019