Provider First Line Business Practice Location Address:
4212 N 16TH ST
Provider Second Line Business Practice Location Address:
INDIAN HEALTH SVC FEDERAL EMERGENCY RM
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85016-5319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-882-6359
Provider Business Practice Location Address Fax Number:
480-882-4389
Provider Enumeration Date:
05/05/2006