Provider First Line Business Practice Location Address:
124 W THOMAS
Provider Second Line Business Practice Location Address:
CHILDREN'S REHABILITATION SERVICE
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-406-6455
Provider Business Practice Location Address Fax Number:
602-406-7166
Provider Enumeration Date:
10/02/2006