Provider First Line Business Practice Location Address:
5130 W THUNDERBIRD RD STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85306-4876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-439-9000
Provider Business Practice Location Address Fax Number:
602-978-5233
Provider Enumeration Date:
03/01/2007