Organization
OLD TOWN HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEEPA TANDON NP (MANAGER/AUTHORIZED OFFICIAL)
(610) 969-5215
Entity
Organization
Contact information
Practice address
4700 E THOMAS RD STE 106, PHOENIX, AZ 85018-7702
(610) 969-5215
Mailing address
4700 E THOMAS RD STE 106, PHOENIX, AZ 85018-7702
(610) 969-5215
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
03/09/2021
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