19th Avenue Clinic Llc

NPI 1053667709 - Clinic/Center - 261QU0200X

NPI Details
NPI 1053667709
Enumeration Date 07/31/2012
Last Updated 07/31/2012
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name RENEE L RENEE
Position VP OF OPERATIONS
Phone (480) 664-6007
Fax (480) 664-6017
Practice Location
835 W UNIVERSITY DR
MESA AZ, 85201-5555, US
Phone (480) 664-6007
Fax (480) 664-6017
Business Location
PO BOX 32950
PHOENIX AZ, 85064-2950, US
Phone (602) 275-6110
Fax (602) 242-3519
Toxanomy
Taxonomy Code 261QU0200X
License State
License Number
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According to our database, 19th Avenue Clinic Llc NPI is 1053667709, taxonomy code is 261QU0200X 19th Avenue Clinic Llc physically located at 835 W University Dr, Mesa AZ, 85201-5555. NPI Number 1033115704 has the healthcare provider type.

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1053667709 NPI number is provided on an as is basis without warranty of any kind. 1053667709 is maintained by the National Plan & Provider Enumeration System. The contents of 19th Avenue Clinic Llc are for informational purposes only.