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General NPI Number Information
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NPI Number | 1437709508
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Entity Type | Organization
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Legal Business Name | AZMO MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 212 WEST SUPERSTITION BOULEVARD # 101
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120
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Country | US
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Telephone | 480-612-8311
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Fax |
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Provider Business Mailing Address
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Address Line | 6262 E. BROWN RD STE 6
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City | MESA
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State | AZ
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Zip | 85205
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Country | US
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Telephone | 480-528-3181
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW B ONOFREI
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Credential |
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Telephone | 541-391-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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