Provider First Line Business Practice Location Address:
ARIZONA STATE PRISON COMPLEX-YUMA
Provider Second Line Business Practice Location Address:
7125 JUAN SANCHEZ BLVD
Provider Business Practice Location Address City Name:
YUMA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-627-8871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2019