Provider First Line Business Practice Location Address:
1400 S DOBSON ROAD
Provider Second Line Business Practice Location Address:
ATTN AMANDA GUMP/HOSPITALIST
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85202-4707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-412-6788
Provider Business Practice Location Address Fax Number:
480-412-6848
Provider Enumeration Date:
07/22/2006