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General NPI Number Information
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NPI Number | 1073893988
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Entity Type | Organization
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Legal Business Name | INSIDE ACCESS, LLC
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Dates
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Enumeration Date | 08/23/2011
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 4044 E MOUNTAIN VISTA DR
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City | PHOENIX
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State | AZ
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Zip | 85048-7489
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Country | US
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Telephone | 480-374-9019
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Fax |
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Provider Business Mailing Address
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Address Line | 4044 E MOUNTAIN VISTA DR
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City | PHOENIX
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State | AZ
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Zip | 85048-7489
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHILLIP ESTHER
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Credential |
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Telephone | 480-374-9019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | RPT 234094
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License Number State | AZ
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