Provider First Line Business Practice Location Address:
10401 W THUNDERBIRD BLVD
Provider Second Line Business Practice Location Address:
BANNER SUN CITY INTENSIVISTS @ BOSWELL MEDICAL CENTER
Provider Business Practice Location Address City Name:
SUN CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85351-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-876-4744
Provider Business Practice Location Address Fax Number:
623-815-2931
Provider Enumeration Date:
10/12/2006