Liberation, Llc | |
802 N. 5th Pnoenix AZ 85003-1316 | |
(602) 708-9014 | |
(888) 349-1581 |
Full Name | Liberation, Llc |
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Speciality | Clinic/center - Multi-specialty |
Location | 802 N. 5th, Pnoenix, Arizona |
Authorized Official Name and Position | Adeola Adelayo (CEO) |
Authorized Official Contact | 6027089014 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Liberation, Llc 802 N 5th Ave Phoenix AZ 85003-1316 Ph: (602) 559-4922 | Liberation, Llc 802 N. 5th Pnoenix AZ 85003-1316 Ph: (602) 708-9014 |
NPI Number | 1518382274 |
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Provider Enumeration Date | 03/04/2014 |
Last Update Date | 03/04/2014 |
Identifier | Type | State | Issuer |
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1518382274 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | OTC5977 (Arizona) | Primary |