Provider First Line Business Practice Location Address:
HWY 59 AND HC 61 P.O. 5050-PTT
Provider Second Line Business Practice Location Address:
EDVENTURES PROGRAM C/O ROUGH ROCK HIGH SCHOOL
Provider Business Practice Location Address City Name:
CHINLE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-907-6890
Provider Business Practice Location Address Fax Number:
801-944-2940
Provider Enumeration Date:
10/10/2008