Provider First Line Business Practice Location Address:
1216 N. 307TH AVENUE
Provider Second Line Business Practice Location Address:
SAN LUCY CLINIC
Provider Business Practice Location Address City Name:
GILA BEND
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-683-2913
Provider Business Practice Location Address Fax Number:
928-683-2008
Provider Enumeration Date:
01/27/2017