Provider First Line Business Practice Location Address:
200 E CURRY RD
Provider Second Line Business Practice Location Address:
STE 146
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85287-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-965-9396
Provider Business Practice Location Address Fax Number:
480-965-0965
Provider Enumeration Date:
02/05/2009