Isp 4th Avenue | |
3620 N 4th Ave Phoenix AZ 85013-3907 | |
(602) 285-1800 | |
(602) 285-1838 |
Full Name | Isp 4th Avenue |
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Speciality | Clinic/center |
Location | 3620 N 4th Ave, Phoenix, Arizona |
Authorized Official Name and Position | Annette Iniguez (EXECUTIVE ASSISTANT) |
Authorized Official Contact | 6022850505 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Isp 4th Avenue 1201 E Thomas Rd Phoenix AZ 85014-5734 Ph: (602) 285-1800 | Isp 4th Avenue 3620 N 4th Ave Phoenix AZ 85013-3907 Ph: (602) 285-1800 |
NPI Number | 1134257769 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134257769 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Arizona) | Primary |
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