Organization Name: | TRI-CITY EXPRESS CARE, PLLC |
NPI Number: | 1609115997 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL P. DUNN (CMO) |
Mailing Address: | 3131 E Thunderbird Rd Suite 73 Phoenix |
State: | AZ US |
Postal Code: | 850325600 |
Phone Number: | 6231234567 |
Fax Number: | 6233456789 |
NPI Enumeration Date: | 02/06/2013 |
NPI Last Update Date: | 02/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |