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Organization

B-HEALTHY MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA CHARMELE BRINSON (OWNER)
(623) 247-2300
Entity
Organization

Contact information

Practice address
4502 W. INDIAN SCHOOL ROAD, #A3, PHOENIX, AZ 85031-3718
(623) 247-0414
(623) 247-0412
Mailing address
9150 W. INDIAN SCHOOL ROAD, #105, PHOENIX, AZ 85037
(623) 247-2300
(623) 247-1939

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1255310967
DEIDREJSOLBERG-DANIELSMD
AZ
01
1265408975
DAVID BICKLER
AZ
01
1972679181
ETHAN KENNEDY
AZ
Enumeration date
06/04/2007
Last updated
04/12/2011
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