Provider First Line Business Practice Location Address:
20201 N SCOTTSDALE HEALTHCARE DR
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85255-4134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-374-2935
Provider Business Practice Location Address Fax Number:
480-374-2940
Provider Enumeration Date:
09/22/2005