Provider First Line Business Practice Location Address:
7701 E INDIAN SCHOOL RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85251-4041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-949-8427
Provider Business Practice Location Address Fax Number:
480-949-8508
Provider Enumeration Date:
07/02/2005