Provider First Line Business Practice Location Address:
1155 N. PINAL PARKWAY
Provider Second Line Business Practice Location Address:
CENTRAL AZ DETENTION CENTER
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-868-3668
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2014