Organization · NPI-2

Amanda Misinco, PLLC

Clinic/Center · Tempe, AZ

NPI number1730478389
StatusActive
Last updated in NPPESDec 3, 2012

Details

NPI
1730478389
Entity type
Organization (NPI-2)
Legal business name
Amanda Misinco, PLLC
Organization subpart
No
Enumeration date
Apr 5, 2011
Last updated
Dec 3, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center1686AZYes

Other names

  • Optical Intuitions (Doing Business As)

Practice location

9855 S Priest Dr
Suite 101
Tempe, AZ 85284-3605

Phone 480-785-4804 · Fax 480-940-1832

Mailing address

2206 N 24th St
Mesa, AZ 85213-2245

Phone 480-478-9562

Authorized official

Amanda S Misinco
Sole Member
4807854804

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