Organization
SELAH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRISON HATFIELD (PRESIDENT)
(928) 708-9960
Entity
Organization
Contact information
Practice address
240 S MONTEZUMA ST, SUITE 206, PRESCOTT, AZ 86303-4712
(928) 708-9960
Mailing address
240 S MONTEZUMA ST, SUITE 206, PRESCOTT, AZ 86303-4712
(928) 708-9960
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
BL-01985
AZ
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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