Organization
ARIZONA MEDICAL BOUTIQUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUREE KRISTINE OLDEHOEFT PA-C (PHYSICIAN ASSISTANT)
(480) 766-0550
Entity
Organization
Contact information
Practice address
35017 N 30TH DR, PHOENIX, AZ 85086-3224
(480) 766-0550
(623) 581-7499
Mailing address
35017 N 30TH DR, PHOENIX, AZ 85086-3224
(480) 766-0550
(623) 581-7499
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
3164
AZ
Other
Enumeration date
06/01/2007
Last updated
08/22/2020
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