Provider First Line Business Practice Location Address:
1000 E CAMELBACK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85014-3225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-279-7376
Provider Business Practice Location Address Fax Number:
602-279-2558
Provider Enumeration Date:
05/15/2007