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Organization
MEN'S VITALITY & PERFORMANCE
Active
Organization
MEN'S VITALITY & PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RISI (OWNER)
(602) 314-5119
Entity
Organization
Contact information
Practice address
4626 E SHEA BLVD, SUITE C230, PHOENIX, AZ 85028-3071
(602) 314-5119
(602) 368-4071
Mailing address
4626 E SHEA BLVD, SUITE 230, PHOENIX, AZ 85028-3071
(602) 314-5119
(602) 368-4071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2830
AZ
Other
Enumeration date
03/03/2011
Last updated
03/03/2011
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