Provider First Line Business Practice Location Address:
HOUSE AZ. 26-24-CH47
Provider Second Line Business Practice Location Address:
A J MEDICAL TRANSPORT SAN ISIDRO COMM.
Provider Business Practice Location Address City Name:
SELLS
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-383-1400
Provider Business Practice Location Address Fax Number:
520-383-1400
Provider Enumeration Date:
05/16/2007