Organization
ALL SPORTS FOUNDATION, INC
Active
Other names
Prostate On-Site Projects, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE M. FELKER (CEO/FOUNDER)
(480) 964-3013
Entity
Organization
Contact information
Practice address
322 E BROWN RD STE 103, MESA, AZ 85201-3563
(480) 964-3013
(480) 694-1644
Mailing address
322 E BROWN RD STE 103, MESA, AZ 85201-3563
(480) 964-3013
(480) 694-1644
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261QH0100X
BLUE CROSS/BLUE SHIELD
AZ
01
—
261QH0100X
MAYO HEALTH PLAN OF ARIZONA
—
Enumeration date
01/16/2009
Last updated
01/16/2009
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