Organization
THE LYMPHEDEMOBILE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA EASON OT, CLT (OWNER/MANAGER)
(928) 221-9632
Entity
Organization
Contact information
Practice address
4446 E JOEY AVE, FLAGSTAFF, AZ 86004-2415
(928) 221-9632
Mailing address
4446 E JOEY AVE, FLAGSTAFF, AZ 86004-2415
(928) 221-9632
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
5556
AZ
Other
Enumeration date
04/16/2017
Last updated
04/16/2017
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