Organization
LUREA INMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUREA SHELLY INMAN COTA/L (OCCUPATIONAL THERAPY ASSISTANT)
(480) 747-4143
Entity
Organization
Contact information
Practice address
18610 E RAVEN DR, QUEEN CREEK, AZ 85142-5542
(480) 747-4143
Mailing address
18658 E RAVEN DR, QUEEN CREEK, AZ 85142-5542
(480) 747-4143
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
4979
AZ
Other
Enumeration date
01/12/2013
Last updated
01/12/2013
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