Provider First Line Business Practice Location Address:
2627 N. 3RD ST.
Provider Second Line Business Practice Location Address:
STE. 100
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-277-4327
Provider Business Practice Location Address Fax Number:
602-307-5905
Provider Enumeration Date:
10/30/2014