Provider First Line Business Practice Location Address:
KAIBETO BOARDING SCHOOL DORM # 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAIBETO
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86053-2121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-673-3491
Provider Business Practice Location Address Fax Number:
928-673-3494
Provider Enumeration Date:
03/14/2006