Provider First Line Business Practice Location Address:
9675 W CAMELBACK 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:
85037-3667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-849-8000
Provider Business Practice Location Address Fax Number:
602-429-8108
Provider Enumeration Date:
03/17/2015