Provider First Line Business Practice Location Address:
HWY 264-HOPI HEALTH CARE CENTER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SECOND MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86043-0068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-737-6300
Provider Business Practice Location Address Fax Number:
928-737-6333
Provider Enumeration Date:
12/22/2006