Organization
PHOENIX VASCULAR ACCESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSIE BRANDON JOHN HART (CEO)
(480) 468-3219
Entity
Organization
Contact information
Practice address
455 N MESA DR STE 16, MESA, AZ 85201-5936
(480) 468-3219
Mailing address
455 N MESA DR STE 16, MESA, AZ 85201-5936
(480) 468-3219
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
163WA2000X
Administrator Registered Nurse
—
—
174400000X
Specialist
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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