Provider First Line Business Practice Location Address:
6535 W CAMELBACK RD STE 6
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:
85033-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-873-4000
Provider Business Practice Location Address Fax Number:
623-873-9000
Provider Enumeration Date:
11/10/2006