Provider First Line Business Practice Location Address:
8325 W INDIAN SCHOOD 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:
85033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-245-7353
Provider Business Practice Location Address Fax Number:
623-245-7347
Provider Enumeration Date:
12/24/2009