Organization
MOUNTAIN VISTA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD EARL WADE FNP (FAMILY NURSE PRACTITIONER)
(480) 283-7534
Entity
Organization
Contact information
Practice address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 358-6100
Mailing address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 358-6100
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
AP3524
AZ
Other
Enumeration date
02/02/2010
Last updated
08/20/2010
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