Provider First Line Business Practice Location Address:
1025 N. COUNTRY CLUB DR.
Provider Second Line Business Practice Location Address:
MPS SPEC. ED.
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-472-3996
Provider Business Practice Location Address Fax Number:
480-472-3999
Provider Enumeration Date:
10/25/2006