# LUREA INMAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205173150
- **Authorized official:** MRS. LUREA SHELLY INMAN COTA/L (OCCUPATIONAL THERAPY ASSISTANT)
- **Authorized official phone:** (480) 747-4143

## Contact information

- **Practice address:** 18610 E RAVEN DR, QUEEN CREEK, AZ 85142-5542
- **Practice address phone:** (480) 747-4143
- **Mailing address:** 18658 E RAVEN DR, QUEEN CREEK, AZ 85142-5542
- **Mailing address phone:** (480) 747-4143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 4979 | AZ | Yes |

## Other

- **Enumeration date:** 01/12/2013
- **Last updated:** 01/12/2013