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General NPI Number Information
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NPI Number | 1184181778
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Entity Type | Organization
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Legal Business Name | NEW SPIRIT HEALTH LLC
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Dates
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Enumeration Date | 03/01/2019
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 2266 S DOBSON RD STE 200
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City | MESA
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State | AZ
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Zip | 85202-6412
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Country | US
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Telephone | 480-568-2802
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Fax | 866-226-5767
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Provider Business Mailing Address
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Address Line | 2266 S DOBSON RD STE 200
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City | MESA
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State | AZ
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Zip | 85202-6412
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Country | US
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Telephone | 480-568-2802
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Fax | 866-226-5767
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Authorized Official
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Title or Position | OWNER/CEO
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Name | JOHN RISI
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Credential | NP
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Telephone | 602-615-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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