Provider First Line Business Practice Location Address:
13660 N 94TH DR
Provider Second Line Business Practice Location Address:
SUITE A1 PLAZA DEL RIO MEDICAL CENTER
Provider Business Practice Location Address City Name:
PEORIA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85381-4836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-933-0550
Provider Business Practice Location Address Fax Number:
623-933-2722
Provider Enumeration Date:
10/04/2006