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1104416429
BANNER MEDICAL GROUP PEDIATRIC SLEEP, LLC
CASA GRANDE, AZ
NPI
1104416429
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Entity Type
Organization
Authorized Contact
DENNIS LARAWAY
CFO
602-747-4000
Organization Subpart ?
Yes
Primary Taxonomy
261QS1200X Clinic/Center, Sleep Disorder Diagnostic
Enumeration Date
2021-01-20
Last Update Date
2021-12-30
Business Address
BANNER MEDICAL GROUP PEDIATRIC SLEEP, LLC
1828 E FLORENCE BLVD BLDG C STE 136
CASA GRANDE, AZ 85122
Phone number: 520-381-6282
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Mailing Address
BANNER MEDICAL GROUP PEDIATRIC SLEEP, LLC
2901 N CENTRAL AVE STE 160
PHOENIX, AZ 85012-2702
Phone number:
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