Provider First Line Business Practice Location Address:
4002 E MAIN STREET
Provider Second Line Business Practice Location Address:
RED MOUNTAIN ANESTHESIOLOGY SUITE 1
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-981-9151
Provider Business Practice Location Address Fax Number:
480-324-5459
Provider Enumeration Date:
09/27/2006