Organization
BANNER OCCUPATIONAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 239-4456
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
02/21/2007
Last updated
08/22/2020
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