Organization
MARIGOLD ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICTORIA L HARRIS OTR (OCCUPATIONAL THERAPIST)
(520) 236-7692
Entity
Organization
Contact information
Practice address
500 N LENZNER AVE, B-9, SIERRA VISTA, AZ 85635-2167
(520) 236-7692
Mailing address
PO BOX 910, HEREFORD, AZ 85615-0910
(520) 236-7692
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
0651
AZ
Other
Enumeration date
02/05/2012
Last updated
02/05/2012
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