Provider First Line Business Practice Location Address:
7700 E. INDIAN SCHOOL RD.
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-947-7784
Provider Business Practice Location Address Fax Number:
480-945-8395
Provider Enumeration Date:
11/20/2007