Organization
IWC WEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHUE KOTHARI (OWNER)
(404) 423-6840
Entity
Organization
Contact information
Practice address
2338 W ROYAL PALM ROAD, SUITE J, PHOENIX, AZ 85021
(404) 423-6840
Mailing address
2338 W ROYAL PALM ROAD, SUITE J, PHOENIX, AZ 85021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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