Provider First Line Business Practice Location Address:
1200 N BEAVER ST
Provider Second Line Business Practice Location Address:
FLAGSTAFF MEDICAL CENTER BEHAVIORAL HEALTH SERVICES 2ND
Provider Business Practice Location Address City Name:
FLAGSTAFF
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-213-6410
Provider Business Practice Location Address Fax Number:
928-213-6409
Provider Enumeration Date:
07/31/2007