Soulistic Medical Institute | |
26 Tubac Road Suite B Tubac AZ 85646 | |
(520) 398-3970 | |
(520) 398-2944 |
Full Name | Soulistic Medical Institute |
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Speciality | Family Medicine |
Location | 26 Tubac Road, Tubac, Arizona |
Authorized Official Name and Position | Marayeh Cunningham (MANAGING DIRECTOR) |
Authorized Official Contact | 5203983970 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Soulistic Medical Institute Po Box 1990 Tubac AZ 85646-1990 Ph: (520) 398-3970 | Soulistic Medical Institute 26 Tubac Road Suite B Tubac AZ 85646 Ph: (520) 398-3970 |
NPI Number | 1215986104 |
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Provider Enumeration Date | 05/08/2006 |
Last Update Date | 11/29/2011 |
Identifier | Type | State | Issuer |
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1215986104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 3784 (Arizona) | Secondary |
207Q00000X | Family Medicine | 27940 (Arizona) | Primary |