Away Clinic LLC
Clinic/Center in Chandler, AZ. Organization (NPI-2).
NPI number1104559376
StatusActive
Last updated in NPPESJul 20, 2022
Details
- NPI
- 1104559376
- Entity type
- Organization (NPI-2)
- Legal business name
- Away Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jul 6, 2022
- Certification date
- Jul 20, 2022
- Last updated
- Jul 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
2201 W Fairview St Ste 1Chandler, AZ 85224-4712
Phone 480-712-8865
Mailing address
2201 W Fairview St Ste 1Chandler, AZ 85224-4712
Other practice locations
3308 N Higley Rd Ste 103
Mesa, AZ 85215-9781
Mesa, AZ 85215-9781
Phone 480-712-8865
Authorized official
Paige Ellsworth
Operations Coordinator
4807128865
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