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General NPI Number Information
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NPI Number | 1508613050
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Entity Type | Organization
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Legal Business Name | SO VEIN PHLEBOTOMY & DIAGNOSTIC'S
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Dates
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Enumeration Date | 05/02/2024
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 10869 N SCOTTSDALE RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-5280
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Country | US
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Telephone | 480-749-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 22079 N DIETZ DR
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City | MARICOPA
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State | AZ
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Zip | 85138-5553
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Country | US
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Telephone | 480-749-7722
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DAVID LARSEN
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Credential | NURSE PRACTITIONER
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Telephone | 480-274-4351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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