Organization
MA TECH IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERCE WAYCHOFF (OWNER)
(602) 482-2282
Entity
Organization
Contact information
Practice address
3329 E BELL RD STE A2-A5, PHOENIX, AZ 85032-2756
(602) 482-2282
Mailing address
PO BOX 42057, PHOENIX, AZ 85080-2057
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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