Provider First Line Business Practice Location Address:
394.3 HIGHWAY 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAYENTA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-697-4140
Provider Business Practice Location Address Fax Number:
928-697-4142
Provider Enumeration Date:
12/14/2017