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General NPI Number Information
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NPI Number | 1841343894
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CARE OF PRESCOTT VALLEY, INC
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 05/25/2019
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Provider Practice Location Address
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Address Line | 8046 E YAVAPAI RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-8442
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Country | US
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Telephone | 928-772-6707
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 S WEEKES RD
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City | PRESCOTT
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State | AZ
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Zip | 86303-6496
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Country | US
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Telephone | 928-710-3748
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID R BRIANT
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Credential | NP
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Telephone | 928-772-6707
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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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