Provider First Line Business Practice Location Address:
1626 S EDWARD DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-252-5000
Provider Business Practice Location Address Fax Number:
602-323-5070
Provider Enumeration Date:
02/01/2006