Organization
ST PEREGRINE WOUND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIANNE TERESA MASON MD (OWNER)
(605) 371-6244
Entity
Organization
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 246-5576
Mailing address
9551 W COUNTRY CLUB DR, SUN CITY, AZ 85373-1725
(605) 371-6244
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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