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General NPI Number Information
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NPI Number | 1093439762
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Entity Type | Organization
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Legal Business Name | PEORIA URGENT CARE AND WALK IN CLINIC PLLC
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 9163 W UNION HILLS DR STE 107
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City | PEORIA
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State | AZ
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Zip | 85382-8187
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Country | US
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Telephone | 313-948-3055
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Fax |
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Provider Business Mailing Address
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Address Line | 14671 TELEGRAPH RD
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City | REDFORD
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State | MI
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Zip | 48239-3300
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Country | US
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Telephone | 313-948-3055
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Fax |
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Authorized Official
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Title or Position | BUSINESS OPERATIONS MANAGER
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Name | NANCY MOLNAR
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Credential |
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Telephone | 313-948-3055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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