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Organization
SURGERY CENTER AT RIVER ROAD, LLC
Active
Organization
SURGERY CENTER AT RIVER ROAD, LLC
Active
Other names
Aesthetic Surgery at Hacienda Del Sol
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN S MAXWELL M.D. (SHAREHOLDER)
(520) 382-1084
Entity
Organization
Contact information
Practice address
2490 E. RIVER ROAD, SUITE 150, TUCSON, AZ 85718-6522
(520) 382-1084
(520) 615-4572
Mailing address
2490 E. RIVER ROAD, SUITE 150, TUCSON, AZ 85718-6522
(520) 382-1084
(520) 615-4572
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0110903
AZ
Other
Enumeration date
07/01/2006
Last updated
09/22/2014
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