Provider First Line Business Practice Location Address:
5301 E. GRANT RD.
Provider Second Line Business Practice Location Address:
ORTHOPAEDIC BLDG, 1ST FLOOR
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85712-2805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-784-6200
Provider Business Practice Location Address Fax Number:
520-784-6109
Provider Enumeration Date:
08/08/2014