Organization
PRO IOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERCE W WAYCHOFF DC (SOLE MBR)
(602) 482-2282
Entity
Organization
Contact information
Practice address
3329 E BELL RD STE A2-A5, PHOENIX, AZ 85032-2756
(602) 482-2282
Mailing address
2801 CENTERVILLE RD FIRST FLOOR, PMB #711, WILMINGTON, DE 19808-1609
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
07/22/2020
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