Provider First Line Business Practice Location Address:
3269 STOCKTON HILL RD.
Provider Second Line Business Practice Location Address:
KINGMAN REGIONAL MEDICAL CENTER, HOSPITAL MEDICINE
Provider Business Practice Location Address City Name:
KINGMAN
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-681-8577
Provider Business Practice Location Address Fax Number:
480-383-6121
Provider Enumeration Date:
09/26/2006