Organization
VESTRA LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW NAGELBUSH (CEO)
(623) 205-3445
Entity
Organization
Contact information
Practice address
11036 N 23RD AVE STE 8, PHOENIX, AZ 85029-4800
(623) 334-1390
Mailing address
11036 N 23RD AVE STE 8, PHOENIX, AZ 85029-4800
(623) 334-1390
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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