PONDEROSA FAMILY CARE, LLC

PAYSON, AZ
NPI1144535626
Entity TypeOrganization
Authorized ContactALAN P MICHELS
Physician
928-468-8603
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: AZ  29337)
Additional Taxonomies208000000X Pediatrics
(Licence: AZ  29337)
Enumeration Date2010-08-09
Last Update Date2014-12-05
Business Address
PONDEROSA FAMILY CARE, LLC
806 S PONDEROSA ST
PAYSON, AZ 85541-5541
Phone number: 928-468-8603
Mailing Address
PONDEROSA FAMILY CARE, LLC
PO BOX 2901
PAYSON, AZ 85547-2901
Phone number: 928-468-9280