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General NPI Number Information
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NPI Number | 1144916826
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Entity Type | Organization
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Legal Business Name | LIVING MEDICINE CENTER FOR OPTIMAL HEALTH
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 144 LAKESIDE ST
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City | PRESCOTT
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State | AZ
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Zip | 86305-5010
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Country | US
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Telephone | 206-718-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 144 LAKESIDE ST
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City | PRESCOTT
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State | AZ
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Zip | 86305-5010
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Country | US
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Telephone | 206-718-4343
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANN MCCOMBS
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Credential | DO
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Telephone | 206-718-4343
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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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