Provider First Line Business Practice Location Address:
975 S. MYRTLE AVE
Provider Second Line Business Practice Location Address:
LATTIE F. COOR HALL, 2ND FLOOR
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-965-2373
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2007