Organization
THE SOAR CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH EICH PA-C (OWNER)
(801) 380-2000
Entity
Organization
Contact information
Practice address
815 N MAIN ST SUITE D, TAYLOR, AZ 85939
(928) 536-4322
Mailing address
PO BOX 186, TAYLOR, AZ 85939-0186
(928) 536-4322
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619221694
—
AZ
Enumeration date
11/14/2023
Last updated
04/02/2024
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