Provider First Line Business Practice Location Address:
3833 E INDIAN SCHOOL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85018-5234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-508-8300
Provider Business Practice Location Address Fax Number:
602-241-1036
Provider Enumeration Date:
01/05/2007