| |
14379 W Eugene Ter Surprise AZ 85379-6194 | |
(202) 681-1274 | |
Not Available |
Full Name | |
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Speciality | Family Medicine - Geriatric Medicine |
Location | 14379 W Eugene Ter, Surprise, Arizona |
Authorized Official Name and Position | Aspen Decker (PRESIDENT) |
Authorized Official Contact | 2026811274 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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14379 W Eugene Ter Surprise AZ 85379-6194 Ph: (202) 681-1274 | 14379 W Eugene Ter Surprise AZ 85379-6194 Ph: (202) 681-1274 |
NPI Number | 1285365114 |
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Provider Enumeration Date | 06/21/2022 |
Last Update Date | 12/13/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285365114 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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