Organization
ADVANCED METABOLIC TESTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA SPARKS (OWNER)
(480) 296-3621
Entity
Organization
Contact information
Practice address
1425 S GREENFIELD RD STE 101, MESA, AZ 85206-5505
(480) 981-3000
Mailing address
4802 E RAY RD # 23-231, PHOENIX, AZ 85044-6405
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578088506
—
AZ
Enumeration date
10/31/2017
Last updated
03/17/2018
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