Provider First Line Business Practice Location Address:
VA MEDICAL CTR # 5-126
Provider Second Line Business Practice Location Address:
3601 S. 6TH AVENUE
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85723-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-792-1450
Provider Business Practice Location Address Fax Number:
520-629-4707
Provider Enumeration Date:
08/22/2006