Provider First Line Business Practice Location Address:
1919 EAST THOMAS RD MAIN BUILDING, 2ND FLOOR
Provider Second Line Business Practice Location Address:
PHOENIX CHILDRENS HOSPITAL
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-933-0935
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2006