| Da Legacy Llc | |
|
899 N Wilmot Rd Ste D5 Tucson AZ 85711 | |
| (520) 475-7791 | |
| Not Available |
| Full Name | Da Legacy Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 899 N Wilmot Rd Ste D5, Tucson, Arizona |
| Authorized Official Name and Position | Anthony Fitzgerald Henry (OWNER) |
| Authorized Official Contact | 5204757791 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Da Legacy Llc 899 N Wilmot Rd Ste D5 Tucson AZ 85711 Ph: (520) 475-7791 | Da Legacy Llc 899 N Wilmot Rd Ste D5 Tucson AZ 85711 Ph: (520) 475-7791 |
| NPI Number | 1043902620 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043902620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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