Organization
BANNER WHOLE HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE EASTER (ADMINISTRATOR)
(520) 694-5753
Entity
Organization
Contact information
Practice address
535 N, WIMONT, TUCSON, AZ 85711
(520) 694-9457
Mailing address
535 N, WIMONT, TUCSON, AZ 85711
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
LPC-2371
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014P2500X
NPI
AZ
Enumeration date
01/14/2016
Last updated
01/14/2016
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