Great Tower Recovery, LLC
Clinic/Center, Multi-Specialty in Phoenix, AZ. Organization (NPI-2).
NPI number1831801232
StatusActive
Last updated in NPPESDec 16, 2022
Details
- NPI
- 1831801232
- Entity type
- Organization (NPI-2)
- Legal business name
- Great Tower Recovery, LLC
- Organization subpart
- No
- Enumeration date
- Dec 16, 2022
- Certification date
- Dec 16, 2022
- Last updated
- Dec 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
Practice location
5501 N 19th Ave Ste 331Phoenix, AZ 85015-2455
Phone 480-262-4547
Mailing address
31925 N 125th AvePeoria, AZ 85383-5675
Authorized official
Ifiok Umoren
Co-Owner
4802624547
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