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2002 E Osborn Rd Phoenix AZ 85016-7236 | |
| (602) 263-5242 | |
| (602) 595-4434 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 2002 E Osborn Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Chris Riley (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 6022635242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2002 E Osborn Rd Ste A Phoenix AZ 85016-7236 Ph: (602) 263-5242 | 2002 E Osborn Rd Phoenix AZ 85016-7236 Ph: (602) 263-5242 |
| NPI Number | 1649818501 |
|---|---|
| Provider Enumeration Date | 12/11/2019 |
| Last Update Date | 10/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649818501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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