Provider First Line Business Practice Location Address:
999 E FRY BLVD STE 305
Provider Second Line Business Practice Location Address:
C/O ALTERNATIVES COUNSELING SERVICE, INC. (PEGG)
Provider Business Practice Location Address City Name:
SIERRA VISTA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85635-2620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-495-1148
Provider Business Practice Location Address Fax Number:
520-459-1454
Provider Enumeration Date:
11/03/2010