Provider First Line Business Practice Location Address:
1500 W. MAIN ST. STE 300
Provider Second Line Business Practice Location Address:
PHOENIX COUNSELING
Provider Business Practice Location Address City Name:
SUN PRAIRIE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53590
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-825-6711
Provider Business Practice Location Address Fax Number:
608-834-6499
Provider Enumeration Date:
08/27/2008