Lone Wolf Medicine, Inc

NPI 1053504225 - Physician Assistant - 363AM0700X

NPI Details
NPI 1053504225
Enumeration Date 08/21/2007
Last Updated 08/21/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARILYN F MARILYN
Position PHYSICIAN ASSISITANT
Phone (928) 474-6617
Fax (928) 474-7059
Practice Location
806 S PONDEROSA ST
PAYSON AZ, 85541-5541, US
Phone (928) 474-6617
Fax (928) 474-7059
Business Location
PO BOX 1670
PAYSON AZ, 85547-1670, US
Phone (928) 474-6617
Fax (928) 474-7059
Toxanomy
Taxonomy Code 363AM0700X
License State Arizona
License Number 1454
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According to our database, Lone Wolf Medicine, Inc NPI is 1053504225, taxonomy code is 363AM0700X and license number is 1454, license state is located at Arizona. Lone Wolf Medicine, Inc physically located at 806 S Ponderosa St, Payson AZ, 85541-5541. NPI Number 1033115704 has the healthcare provider type.

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1053504225 NPI number is provided on an as is basis without warranty of any kind. 1053504225 is maintained by the National Plan & Provider Enumeration System. The contents of Lone Wolf Medicine, Inc are for informational purposes only.