Organization
INNOVATIVE NEUROPATHY TREATMENT INSTITUTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN DOHERTY (MANAGING PARTNER)
(313) 549-0430
Entity
Organization
Contact information
Practice address
16601 N 40TH ST, SUITE 110, PHOENIX, AZ 85032-3345
(480) 478-0780
(480) 478-0655
Mailing address
16601 N 40TH ST, SUITE 110, PHOENIX, AZ 85032-3345
(480) 478-4780
(480) 478-0655
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207YX0901X
Otology & Neurotology Physician
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
06/02/2015
Last updated
09/29/2015
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