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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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