Organization
ARIZONA LS, LLC
Active
Other names
Medi Weightloss Billerica
Organization subpart
No
Provider details
NPI number
Authorized official
WENDIE NONCLERC (DIRECTOR OF INSURANCE DEVELOPMENT)
(813) 228-6334
Entity
Organization
Contact information
Practice address
509 S HYDE PARK AVE, TAMPA, FL 33606-2266
(813) 228-6334
Mailing address
99 CHELMSFORD RD, SUITE 8 NORTH, NORTH BILLERICA, MA 01862-1350
(978) 244-0411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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