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1104162288
BETHEL
TUCSON, AZ
NPI
1104162288
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Entity Type
Organization
Authorized Contact
KOFFI SEDDO
Administrator Provider
520-891-0081
Organization Subpart ?
No
Primary Taxonomy
251S00000X
(Licence: AZ BH-4113)
Enumeration Date
2012-12-18
Last Update Date
2012-12-18
Business Address
BETHEL
9820 E PASEO SAN BERNARDO
TUCSON, AZ 85747-5022
Phone number: 520-891-0081
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Mailing Address
BETHEL
9820 E PASEO SAN BERNARDO
TUCSON, AZ 85747-5022
Phone number:
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