Organization
MOLLED TRAVEL VACCINES, PLLC
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
(480) 646-9020
Entity
Organization
Contact information
Practice address
14985 W. BELL ROAD, BUILDING 12-A #100, SURPRISE, AZ 85374-3231
(877) 358-8648
(877) 877-6875
Mailing address
668 N 44TH ST, SUITE 100W, PHOENIX, AZ 85008-6507
(877) 358-8648
(480) 546-3421
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
08/03/2022
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