Provider First Line Business Practice Location Address:
FORT DEFIANCE INDIAN HOSPITAL
Provider Second Line Business Practice Location Address:
CORNER OF RT N12 & N7
Provider Business Practice Location Address City Name:
FT. DEFIANCE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-729-8525
Provider Business Practice Location Address Fax Number:
928-729-8530
Provider Enumeration Date:
10/31/2006