Provider First Line Business Practice Location Address:
200 W HOSPITAL DR.
Provider Second Line Business Practice Location Address:
WHITERIVER SERVICE UNIT
Provider Business Practice Location Address City Name:
WHITERIVER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-338-4911
Provider Business Practice Location Address Fax Number:
928-338-3522
Provider Enumeration Date:
05/30/2013