Provider First Line Business Practice Location Address:
4530 W CAMPBELL AVE
Provider Second Line Business Practice Location Address:
ANDALUCIA PRIMARY SCHOOL
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85031-1400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-848-8420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2007