Provider First Line Business Practice Location Address:
1111 EAST MCDOWELL ROAD
Provider Second Line Business Practice Location Address:
BANNER GOOD SAMARITAN ACADEMIC MEDICAL SERVICES
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-239-5982
Provider Business Practice Location Address Fax Number:
602-239-5918
Provider Enumeration Date:
11/03/2009