Full Name | |
---|---|
Speciality | Clinic/center |
Location | 101 Medicine Road, Bylas, Arizona |
Authorized Official Name and Position | Victoria Began (CEO) |
Authorized Official Contact | 9284751208 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 787 Peridot AZ 85542-0787 Ph: (928) 475-1200 | 101 Medicine Road Bylas AZ 85530 Ph: (928) 475-7142 |
NPI Number | 1417330713 |
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Provider Enumeration Date | 07/06/2015 |
Last Update Date | 12/18/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417330713 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |