| NPI | 1740055599 |
|---|---|
| Doing Business As | GRAND WEST FAMILY PRACTICE AND WELLNESS LLC |
| Entity Type | Organization |
| Authorized Contact | SHELLY TELLMAN Owner/Manager 623-824-5017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2024-02-06 |