Provider First Line Business Practice Location Address:
505 W MCDOWELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85003-1259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-565-6000
Provider Business Practice Location Address Fax Number:
602-252-0006
Provider Enumeration Date:
10/04/2006