Organization
VITAL4MEN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD DISHON (PARTNER/MEMBER)
(623) 218-1515
Entity
Organization
Contact information
Practice address
4140 E BASELINE RD, STE 111, MESA, AZ 85206-4412
(480) 825-7615
(480) 248-7658
Mailing address
7707 W DEER VALLEY RD, STE 115, PEORIA, AZ 85382-2101
(623) 218-1515
(623) 566-0019
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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