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General NPI Number Information
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NPI Number | 1003695206
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Entity Type | Organization
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Legal Business Name | ARIZONA ALLY MEDICAL PLLC
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 4326 E SAINT JOHN RD
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City | PHOENIX
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State | AZ
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Zip | 85032-2285
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Country | US
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Telephone | 801-822-4516
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 E CAMELBACK RD STE 102
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City | PHOENIX
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State | AZ
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Zip | 85016-4165
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Country | US
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Telephone | 480-378-6707
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Fax | 480-248-3132
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA ZUBER
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Credential | FNP-C
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Telephone | 480-378-7607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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