Organization Name: | AFC PHYSICAL MEDICINE OF FOUNTAIN HILLS |
NPI Number: | 1629342654 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VERNA M PALACIO (CORPORATE MANAGER) |
Mailing Address: | 17100 E Shea Blvd Suite 320 Fountain Hills |
State: | AZ US |
Postal Code: | 852686625 |
Phone Number: | 4808168300 |
Fax Number: | 4808164016 |
NPI Enumeration Date: | 03/08/2012 |
NPI Last Update Date: | 03/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
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