Organization
BTC CLINIC 1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE DECKER CPC (CREDENTIALING MANAGER)
(480) 269-2971
Entity
Organization
Contact information
Practice address
20880 W DIXIE HWY STE 105, AVENTURA, FL 33180-1151
(786) 657-3941
Mailing address
70 S VAL VISTA DR STE A3-659, GILBERT, AZ 85296-1374
(480) 269-2971
(480) 452-0691
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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