Organization
VITAL4MEN CHANDLER PLLC
Active
Organization
VITAL4MEN CHANDLER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WRAY (MEMBER)
(623) 399-8606
Entity
Organization
Contact information
Practice address
655 S DOBSON RD, BLDG. B SUITE #216, CHANDLER, AZ 85224-5667
(623) 399-8606
(623) 399-9958
Mailing address
7707 W DEER VALLEY RD, STE 115, PEORIA, AZ 85382-2101
(623) 399-8606
(623) 399-9958
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
15568
AZ
Other
Enumeration date
12/05/2013
Last updated
01/03/2014
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