Provider First Line Business Practice Location Address:
1111 E MCDOWELL ROAD
Provider Second Line Business Practice Location Address:
BANNER GOOD SAMARITAN REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-239-2147
Provider Business Practice Location Address Fax Number:
602-239-2581
Provider Enumeration Date:
04/20/2006