Provider First Line Business Practice Location Address:
INDIAN ROUTE 64 AND 12
Provider Second Line Business Practice Location Address:
TSAILE HEALTH CLINIC
Provider Business Practice Location Address City Name:
TSAILE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85665-0021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-724-3707
Provider Business Practice Location Address Fax Number:
928-724-3781
Provider Enumeration Date:
08/20/2006