Organization · NPI-2

Allergy Incorporated

Nurse Practitioner, Family · Buckeye, AZ

NPI number1356672182
StatusActive
Last updated in NPPESJan 19, 2010

Details

NPI
1356672182
Entity type
Organization (NPI-2)
Legal business name
Allergy Incorporated
Organization subpart
No
Enumeration date
Jan 19, 2010
Last updated
Jan 19, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyAP3102AZYes

Practice location

20518 W White Rock Rd
Buckeye, AZ 85396-7750

Phone 650-924-1174

Mailing address

20518 W White Rock Rd
Buckeye, AZ 85396-7750

Authorized official

Kevin Lee Letz
Ceo
6509241174

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