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Organization
PHOENIX IONM, LLC.
Active
Organization
PHOENIX IONM, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN KIDD CNIM (CHIEF OPERATING OFFICER)
(217) 821-0759
Entity
Organization
Contact information
Practice address
11 OHRAZDA LN, EAST WENATCHEE, WA 98802-9335
(720) 435-5129
Mailing address
5856 S LOWELL BLVD # 32-403, LITTLETON, CO 80123-7915
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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