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General NPI Number Information
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NPI Number | 1841792181
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Entity Type | Organization
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Legal Business Name | BALANCE HORMONE PEORIA PLLC
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 15396 N 83RD AVE
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City | PEORIA
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State | AZ
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Zip | 85381-5622
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Country | US
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Telephone | 632-487-1997
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15782
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City | OKLAHOMA CITY
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State | OK
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Zip | 73155-5782
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Country | US
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Telephone | 405-455-3964
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Fax | 210-800-9921
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Authorized Official
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Title or Position | MD
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Name | MR. BRIAN CAFARO
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Credential | MD
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Telephone | 623-487-1997
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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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