Provider First Line Business Practice Location Address:
1617 S 67TH AVE
Provider Second Line Business Practice Location Address:
FOWLER SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-707-4500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2007