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Organization
VIP IV & MEDICAL SPA, LLC
Active
Organization
VIP IV & MEDICAL SPA, LLC
Active
Other names
VIP IV & Medical SPA, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLEY ROBIN FARLEY FNP-C (OWNER, FAMILY NURSE PRACTITIONER)
(480) 404-4896
Entity
Organization
Contact information
Practice address
1690 MCCULLOCH BLVD N STE 102, LAKE HAVASU CITY, AZ 86403-6560
(480) 404-4896
(480) 400-1063
Mailing address
1747 LOS LAGOS DR, LAKE HAVASU CITY, AZ 86403-6625
(480) 404-4896
(480) 400-1063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
Other
Enumeration date
08/02/2023
Last updated
01/11/2024
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