Provider First Line Business Practice Location Address:
2601 E. ROOSEVELT ST.
Provider Second Line Business Practice Location Address:
MARICOPA INTEGRATED HEALTH SYSTEM
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-396-6397
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2015