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1386287753
SAN JOSE INTEGRATED CLINIC LLC
SAN LUIS, AZ
NPI
1386287753
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Entity Type
Organization
Authorized Contact
CLARISSE VANESSA NGUEHANANA
CEO
928-722-6098
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2019-10-17
Last Update Date
2019-10-17
Business Address
SAN JOSE INTEGRATED CLINIC LLC
2000 E JUAN SANCHEZ BLVD
SAN LUIS, AZ 85336-0481
Phone number: 928-722-6098
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Mailing Address
SAN JOSE INTEGRATED CLINIC LLC
2575 W 24TH ST APT 168
YUMA, AZ 85364-6066
Phone number: 928-722-6098
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