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Organization
GRAND WEST FAMILY PRACTICE AND WELLNESS LLC
Active
Organization
GRAND WEST FAMILY PRACTICE AND WELLNESS LLC
Active
Other names
GRAND WEST FAMILY PRACTICE AND WELLNESS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY TELLMAN FNP-C (OWNER/MANAGER)
(623) 824-5017
Entity
Organization
Contact information
Practice address
13000 N 103RD AVE STE 77, SUN CITY, AZ 85351-3057
(480) 284-5650
(480) 284-6431
Mailing address
13000 N 103RD AVE STE 77, SUN CITY, AZ 85351-3057
(480) 284-5650
(480) 284-6431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
02/06/2024
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