| Vital4men, Pllc | |
|
4140 E Baseline Rd Ste 111 Mesa AZ 85206-4412 | |
| (480) 825-7615 | |
| (480) 248-7658 |
| Full Name | Vital4men, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 4140 E Baseline Rd, Mesa, Arizona |
| Authorized Official Name and Position | Todd Dishon (PARTNER/MEMBER) |
| Authorized Official Contact | 6232181515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital4men, Pllc 7707 W Deer Valley Rd Ste 115 Peoria AZ 85382-2101 Ph: (623) 218-1515 | Vital4men, Pllc 4140 E Baseline Rd Ste 111 Mesa AZ 85206-4412 Ph: (480) 825-7615 |
| NPI Number | 1619323045 |
|---|---|
| Provider Enumeration Date | 05/04/2016 |
| Last Update Date | 05/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619323045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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