Provider First Line Business Practice Location Address:
1300 S. 10 STREET
Provider Second Line Business Practice Location Address:
WESLEY COMMUNITY & HEALTH CENTER
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-368-9603
Provider Business Practice Location Address Fax Number:
602-257-4338
Provider Enumeration Date:
06/29/2006