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1992321723
PONDEROSA FAMILY CARE, LLC
PAYSON, AZ
NPI
1992321723
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Entity Type
Organization
Authorized Contact
ALAN P MICHELS
Physician/Owner
928-468-8603
Organization Subpart ?
No
Primary Taxonomy
261QR1300X Clinic/Center Rural Health
Enumeration Date
2020-06-17
Last Update Date
2020-06-17
Business Address
PONDEROSA FAMILY CARE, LLC
127 E MAIN ST STE D
PAYSON, AZ 85541-5646
Phone number: 928-468-8603
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Mailing Address
PONDEROSA FAMILY CARE, LLC
PO BOX 2901
PAYSON, AZ 85547-2901
Phone number: 928-468-8603
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