Provider First Line Business Practice Location Address:
USPHS IHS FEDERAL FACILITY
Provider Second Line Business Practice Location Address:
FORT DEFIANCE HOSPITAL
Provider Business Practice Location Address City Name:
FORT DEFIANCE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86504-0649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-729-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2006