Provider First Line Business Practice Location Address:
140 W SPEEDWAY
Provider Second Line Business Practice Location Address:
SUITE 100 ST ELIZABETH OF HUNGARY CLINIC
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85705-7698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-628-7871
Provider Business Practice Location Address Fax Number:
520-205-8461
Provider Enumeration Date:
12/26/2006