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Park Estates #49 Sun Lane Sanders AZ 86512 | |
(928) 688-3903 | |
(928) 688-4471 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | Park Estates #49 Sun Lane, Sanders, Arizona |
Authorized Official Name and Position | Dawn Martinez (CONTROLLER) |
Authorized Official Contact | 9288103800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 370 St Michaels AZ 86511-0370 Ph: (928) 810-3800 | Park Estates #49 Sun Lane Sanders AZ 86512 Ph: (928) 688-3903 |
NPI Number | 1629209622 |
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Provider Enumeration Date | 08/07/2009 |
Last Update Date | 08/07/2009 |
Identifier | Type | State | Issuer |
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1629209622 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 0327230 (Arizona) | Primary |