Provider First Line Business Practice Location Address:
1041 HANCOCK RD, STE A
Provider Second Line Business Practice Location Address:
AKDHC, LLC
Provider Business Practice Location Address City Name:
BULLHEAD CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86442-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-704-7011
Provider Business Practice Location Address Fax Number:
928-704-7014
Provider Enumeration Date:
11/20/2007