Provider First Line Business Practice Location Address:
1920 E BASELINE RD
Provider Second Line Business Practice Location Address:
CJ HARRIS CLINIC
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85283-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-345-5085
Provider Business Practice Location Address Fax Number:
480-345-5266
Provider Enumeration Date:
12/21/2005