Provider First Line Business Practice Location Address:
56TH MEDICAL GROUP ALLERGY/IMMUNIZATIONS CLINIC
Provider Second Line Business Practice Location Address:
7219 NORTH LITCHFIELD ROAD
Provider Business Practice Location Address City Name:
LUKE AFB
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-856-7420
Provider Business Practice Location Address Fax Number:
602-429-8356
Provider Enumeration Date:
08/31/2005