Organization
AWAY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAIGE ELLSWORTH (OPERATIONS COORDINATOR)
(480) 712-8865
Entity
Organization
Contact information
Practice address
2201 W FAIRVIEW ST STE 1, CHANDLER, AZ 85224-4712
(480) 712-8865
Mailing address
2201 W FAIRVIEW ST STE 1, CHANDLER, AZ 85224-4712
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/06/2022
Last updated
07/20/2022
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