Provider First Line Business Practice Location Address:
NAVAJO ROUTE 12
Provider Second Line Business Practice Location Address:
WRUSD NO 8 SPECIAL EDUCATION DEPARTMENT
Provider Business Practice Location Address City Name:
FORT DEFIANCE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86504-0559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-729-6761
Provider Business Practice Location Address Fax Number:
928-729-7630
Provider Enumeration Date:
09/10/2007