Organization
BILLY CREEK CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L LARUE (BILLING)
(928) 333-5333
Entity
Organization
Contact information
Practice address
43 W WHITE MOUNTAIN BLVD, LAKESIDE, AZ 85929-7002
(928) 367-4040
(928) 367-4042
Mailing address
PO BOX 878, SPRINGERVILLE, AZ 85938-0878
(928) 333-5333
(928) 333-5100
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
32794
AZ
Other
Enumeration date
05/20/2008
Last updated
05/27/2008
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