Organization · NPI-2

Ageless Secret

Family Medicine · Scottsdale, AZ

NPI number1659610145
StatusActive
Last updated in NPPESMar 14, 2013

Details

NPI
1659610145
Entity type
Organization (NPI-2)
Legal business name
Ageless Secret
Organization subpart
No
Enumeration date
Feb 5, 2013
Last updated
Mar 14, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineAP4668AZYes

Practice location

7425 E Shea Blvd
Suite 103
Scottsdale, AZ 85260-6411

Phone 480-948-3250 · Fax 480-948-3750

Mailing address

7425 E Shea Blvd
Suite 103
Scottsdale, AZ 85260-6411

Phone 480-948-3250 · Fax 480-948-3750

Authorized official

Julie T Zafuto
Owner
4809483250

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