| |
15655 W Roosevelt St Ste 243 Goodyear AZ 85338-9306 | |
(480) 443-0384 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 15655 W Roosevelt St Ste 243, Goodyear, Arizona |
Authorized Official Name and Position | Amanda Wilkinson (BUSINESS OPERATIONS DIRECTOR) |
Authorized Official Contact | 7028180446 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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15655 W Roosevelt St Ste 243 Goodyear AZ 85338-9306 Ph: () - | 15655 W Roosevelt St Ste 243 Goodyear AZ 85338-9306 Ph: (480) 443-0384 |
NPI Number | 1881263853 |
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Provider Enumeration Date | 06/23/2021 |
Last Update Date | 11/11/2024 |
Identifier | Type | State | Issuer |
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1881263853 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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