Provider First Line Business Practice Location Address:
7201 E CAMELBACK RD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85251-3325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-423-3161
Provider Business Practice Location Address Fax Number:
480-423-8240
Provider Enumeration Date:
04/04/2007