Provider First Line Business Practice Location Address:
650 E INDIAN SCHOOL RD (126)
Provider Second Line Business Practice Location Address:
CARL T HAYDEN VAMC
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
95012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-222-6412
Provider Business Practice Location Address Fax Number:
602-222-6588
Provider Enumeration Date:
06/09/2006