| NPI | 1114702370 |
|---|---|
| Other Name | PROSANO HEALTH - PEORIA |
| Entity Type | Organization |
| Authorized Contact | AARON BOWEN Chief Operating Officer 480-493-7249 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2024-11-15 |