Organization
AZ WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIBAN ALMAGUER (OWNER)
(623) 937-8643
Entity
Organization
Contact information
Practice address
6114 N 59TH AVE STE 4, GLENDALE, AZ 85301-7769
(623) 937-8643
Mailing address
6114 N 59TH AVE STE 4, GLENDALE, AZ 85301-7769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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