Organization
KT INTEGRATIVE MEDICINE LLC
Active
Organization
KT INTEGRATIVE MEDICINE LLC
Active
Other names
Ketamine Integrative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNETTE ALTAMIRANO LUSKO DO (MEDICAL DIRECTOR)
(480) 571-3060
Entity
Organization
Contact information
Practice address
633 E RAY RD STE 131, GILBERT, AZ 85296-4206
(480) 571-3060
(480) 571-3061
Mailing address
2824 N POWER RD # 113-471, MESA, AZ 85215-1672
(480) 571-3060
(480) 571-3061
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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