| Danjer Blaze Reign Llc | |
|
530 E Hunt Hwy Ste 130 Pmb #493 San Tan Valley AZ 85143-6581 | |
| (480) 256-2958 | |
| Not Available |
| Full Name | Danjer Blaze Reign Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 530 E Hunt Hwy Ste 130 Pmb #493, San Tan Valley, Arizona |
| Authorized Official Name and Position | Danielle Sears (OWNER) |
| Authorized Official Contact | 6026150876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Danjer Blaze Reign Llc 530 E Hunt Hwy Ste 130 Pmb #493 San Tan Valley AZ 85143-6581 Ph: (480) 256-2958 | Danjer Blaze Reign Llc 530 E Hunt Hwy Ste 130 Pmb #493 San Tan Valley AZ 85143-6581 Ph: (480) 256-2958 |
| NPI Number | 1609610666 |
|---|---|
| Provider Enumeration Date | 06/24/2024 |
| Last Update Date | 06/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609610666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
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