The Lodge At 14th St.

NPI 1083698328 - Clinic/Center - 261Q00000X

NPI Details
NPI 1083698328
Enumeration Date 11/30/2005
Last Updated 08/19/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name JOHN JOHN
Position GENERAL PARTNER
Phone (602) 279-1033
Fax (602) 277-5604
Practice Location
2941 N 14TH ST
PHOENIX AZ, 85014-5604, US
Phone (602) 279-1033
Fax (602) 277-5604
Business Location
2941 N. 14TH ST.
PHOENIX AZ, 85014-5604, US
Phone (602) 279-1033
Fax (602) 277-5367
Toxanomy
Taxonomy Code 261Q00000X
License State Arizona
License Number ALC 4746
Remove 1083698328 NPI Number
 

According to our database, The Lodge At 14th St. NPI is 1083698328, taxonomy code is 261Q00000X and license number is ALC 4746, license state is located at Arizona. The Lodge At 14th St. physically located at 2941 N 14th St, Phoenix AZ, 85014-5604. NPI Number 1033115704 has the healthcare provider type.

Sponsored links

1083698328 NPI number is provided on an as is basis without warranty of any kind. 1083698328 is maintained by the National Plan & Provider Enumeration System. The contents of The Lodge At 14th St. are for informational purposes only.