Provider First Line Business Practice Location Address:
4212 NORTH 16TH STREET
Provider Second Line Business Practice Location Address:
DEPARTMENT OF SURGERY
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-263-1511
Provider Business Practice Location Address Fax Number:
602-263-1637
Provider Enumeration Date:
10/05/2006