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General NPI Number Information
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NPI Number | 1548953177
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Entity Type | Organization
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Legal Business Name | ADVANCED TRAINING CONSULTANTS LLC
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 25546 N LAKE PLEASANT PKWY STE 1350-6
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City | PEORIA
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State | AZ
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Zip | 85383-1370
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Country | US
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Telephone | 623-203-1791
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Fax |
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Provider Business Mailing Address
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Address Line | 22220 W MARK LN
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City | WITTMANN
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State | AZ
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Zip | 85361-8793
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Country | US
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Telephone | 623-203-1791
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISTI BRIANA THOMPSON
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Credential | LPN
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Telephone | 623-203-1791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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