| NPI Details | |
|---|---|
| NPI | 1053615906 |
| Enumeration Date | 01/07/2011 |
| Last Updated | 05/07/2015 |
| Entity Type | Healthcare Provider |
| Active | Over 6 years ago |
| Authorized Information | |
|---|---|
| Name | REED T REED |
| Position | OWNER |
| Phone | (480) 307-8809 |
| Fax | (480) 307-8803 |
| Practice Location | |
|---|---|
| 1040 S LEBARON MESA AZ, 85210-3631, US |
|
| Phone | (480) 307-8809 |
| Fax | (480) 307-8803 |
| Business Location | |
|---|---|
| 1040 S LEBARON MESA AZ, 85210-3631, US |
|
| Phone | (480) 307-8809 |
| Fax | (480) 307-8803 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 310400000X |
| License State | Arizona |
| License Number | AL7718C |
| Remove 1053615906 NPI Number | |
According to our database, Heritage Life Center Llc Dba Heritage Lane NPI is 1053615906, taxonomy code is 310400000X and license number is AL7718C, license state is located at Arizona. Heritage Life Center Llc Dba Heritage Lane physically located at 1040 S Lebaron, Mesa AZ, 85210-3631. NPI Number 1033115704 has the healthcare provider type.
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1053615906 NPI number is provided on an as is basis without warranty of any kind. 1053615906 is maintained by the National Plan & Provider Enumeration System. The contents of Heritage Life Center Llc Dba Heritage Lane are for informational purposes only.
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