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Organization

KETAMINE WELLNESS CENTERS PHOENIX LLC

Active
Parent organization
KETAMINE WELLNESS CENTERS ARIZONA LLC
Other names
Ketamine Infusion Centers
Organization subpart
Yes

Provider details

NPI number
Legal business name
KETAMINE WELLNESS CENTERS ARIZONA LLC
Authorized official
ANITA JERGER (EXECUTIVE ASSISTANT)
(480) 993-2227
Entity
Organization

Contact information

Practice address
3724 N 3RD ST STE 201, PHOENIX, AZ 85012-2034
(480) 788-8539
Mailing address
1255 W BASELINE RD STE A-182, MESA, AZ 85202-5820
(480) 993-2227

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Enumeration date
01/06/2022
Last updated
01/10/2022
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