Provider First Line Business Practice Location Address:
3900 E CAMELBACK RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-354-7600
Provider Business Practice Location Address Fax Number:
602-354-7066
Provider Enumeration Date:
11/17/2006