Provider First Line Business Practice Location Address:
701 W WETMORE RD RM 168
Provider Second Line Business Practice Location Address:
AMPHITHEATER PUBLIC SCHOOLS
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85705-1547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-696-5237
Provider Business Practice Location Address Fax Number:
520-696-5067
Provider Enumeration Date:
02/03/2010