Organization
WALTER M DISE
Active
Other names
General Medical Transportation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER DISE (OWNER/PRESIDENT)
(480) 430-5328
Entity
Organization
Contact information
Practice address
34095 N SLATE CREEK DR, QUEEN CREEK, AZ 85243-3420
(480) 430-5328
(480) 354-7247
Mailing address
34095 N SLATE CREEK DR, QUEEN CREEK, AZ 85243-3420
(480) 430-5328
(480) 354-7247
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
9454
AZ
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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