North Phoenix Otc LLC
Clinic/Center, Multi-Specialty in Phoenix, AZ. Organization (NPI-2).
NPI number1235680596
StatusActive
Last updated in NPPESOct 20, 2016
Details
- NPI
- 1235680596
- Entity type
- Organization (NPI-2)
- Legal business name
- North Phoenix Otc LLC
- Organization subpart
- No
- Enumeration date
- Oct 20, 2016
- Last updated
- Oct 20, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
Practice location
3329 E Bell Rd Ste A1-A5Phoenix, AZ 85032
Phone 602-482-2282 · Fax 602-482-2909
Mailing address
3329 E Bell Rd Ste A1-A5Phoenix, AZ 85032
Phone 602-482-2282 · Fax 602-482-2909
Authorized official
Erin L Waychoff
Sole Mbr
6024822282
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