Organization
HAVENLIGHT PLLC
Active
Other names
Havenlight Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN REESER MD (MEDICAL DIRECTOR)
(623) 396-5623
Entity
Organization
Contact information
Practice address
7160 E KIERLAND BLVD, STE 213, SCOTTSDALE, AZ 85254-2987
(623) 396-5623
Mailing address
809 W RIORDAN RD STE 100-132, FLAGSTAFF, AZ 86001-0842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z257365
—
AZ
Enumeration date
04/13/2021
Last updated
04/26/2023
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