Provider First Line Business Practice Location Address:
E. ON HWY. 160 TO ROUTE 59
Provider Second Line Business Practice Location Address:
BEHIND KAYENTA CHAPTER HOUSE
Provider Business Practice Location Address City Name:
KAYENTA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86033-1496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-697-8154
Provider Business Practice Location Address Fax Number:
928-697-8559
Provider Enumeration Date:
03/08/2006