GRAPEVINE CLINIC LLC

FORT MOHAVE, AZ
NPI1164731030
Entity TypeOrganization
Authorized ContactKAYE A CUNNINGHAM
Owner/Member
928-788-6060
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: AZ  28326)
Enumeration Date2010-09-27
Last Update Date2010-09-27
Business Address
GRAPEVINE CLINIC LLC
5300 S HIGHWAY 95 SUITE H
FORT MOHAVE, AZ 86426-9251
Phone number: 928-788-6060
Mailing Address
GRAPEVINE CLINIC LLC
PO BOX 8670
FORT MOHAVE, AZ 86427-8670
Phone number: 928-788-6060
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