Provider First Line Business Practice Location Address:
6601 N 27TH AVENUE
Provider Second Line Business Practice Location Address:
GOMPERS CENTER INC
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-336-0061
Provider Business Practice Location Address Fax Number:
602-336-0249
Provider Enumeration Date:
12/27/2006