Provider First Line Business Practice Location Address:
1230 W WASHINGTON ST
Provider Second Line Business Practice Location Address:
MAIL STOP: AZ-900-04-24
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85281-1245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-794-1400
Provider Business Practice Location Address Fax Number:
610-768-0288
Provider Enumeration Date:
01/16/2008