Az Mobile Medical Clinic LLC
General Practice in Laveen, AZ. Organization (NPI-2).
NPI number1013766484
StatusActive
Last updated in NPPESApr 23, 2025
Details
- NPI
- 1013766484
- Entity type
- Organization (NPI-2)
- Legal business name
- Az Mobile Medical Clinic LLC
- Organization subpart
- No
- Enumeration date
- May 16, 2024
- Certification date
- Apr 23, 2025
- Last updated
- Apr 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
3933 W Thurman DrLaveen, AZ 85339-1232
Phone 602-962-8755 · Fax 602-704-6002
Mailing address
3933 W Thurman DrLaveen, AZ 85339-1232
Phone 602-962-8755 · Fax 602-704-6002
Authorized official
John Richard Groff
Owner
6027232126
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