Provider First Line Business Practice Location Address:
20201 N SCOTTSDALE HEALTHCARE DR STE 145
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85255-4136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-904-4439
Provider Business Practice Location Address Fax Number:
480-591-9774
Provider Enumeration Date:
06/18/2026