Organization
MOLLEN IMMUNIZATION CLINICS OF NORTH AMERICA, INC.
Active
Organization
MOLLEN IMMUNIZATION CLINICS OF NORTH AMERICA, INC.
Active
Other names
MICONA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY A WATTS (SR. VICE PRESIDENT)
(602) 264-9806
Entity
Organization
Contact information
Practice address
4602 N 16TH ST, SUITE 200, PHOENIX, AZ 85016-5189
(602) 264-9806
(602) 264-9846
Mailing address
4602 N 16TH ST, SUITE 200, PHOENIX, AZ 85016-5189
(602) 264-9806
(602) 264-9846
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2007
Last updated
11/14/2007
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