| Southwest Iom Pro Llc | |
|
6401 E Caron Dr Paradise Valley AZ 85253-1862 | |
| (623) 293-3985 | |
| Not Available |
| Full Name | Southwest Iom Pro Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 6401 E Caron Dr, Paradise Valley, Arizona |
| Authorized Official Name and Position | Christopher S Ray (PRESIDENT) |
| Authorized Official Contact | 6232933985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Iom Pro Llc 6401 E Caron Dr Paradise Valley AZ 85253-1862 Ph: (623) 293-3985 | Southwest Iom Pro Llc 6401 E Caron Dr Paradise Valley AZ 85253-1862 Ph: (623) 293-3985 |
| NPI Number | 1801411152 |
|---|---|
| Provider Enumeration Date | 06/12/2020 |
| Last Update Date | 06/12/2020 |
| Certification Date | 06/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801411152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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