Provider First Line Business Practice Location Address:
SOUTHERN INDIAN HEALTH COUNCIL 4058 WILLOWS ROAD
Provider Second Line Business Practice Location Address:
PO BOX 2128
Provider Business Practice Location Address City Name:
ALPINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-445-1188
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2012