OMNI DERMATOLOGY OLIVE LLC

GLENDALE, AZ
NPI1669914172
Entity TypeOrganization
Authorized ContactANDREW JOSEPH RACETTE
President
602-954-3919
Organization Subpart ?No
Primary Taxonomy174400000X Specialist
Enumeration Date2016-11-15
Last Update Date2016-11-15
Business Address
OMNI DERMATOLOGY OLIVE LLC
5700 W OLIVE AVE STE 101
GLENDALE, AZ 85302-3147
Phone number: 602-559-5470
Mailing Address
OMNI DERMATOLOGY OLIVE LLC
4840 E INDIAN SCHOOL RD STE 102
PHOENIX, AZ 85018-5500
Phone number: 602-954-3919
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