Organization
SIR ISAAC LLC
Active
Organization
SIR ISAAC LLC
Active
Other names
Future health and wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MASSA KIAWOIN LAVANT OWNER (MANAGER)
(763) 639-1269
Entity
Organization
Contact information
Practice address
18275 N 59TH AVE STE 128, GLENDALE, AZ 85308-1252
(763) 639-1269
(602) 938-2283
Mailing address
18275 N 59TH AVE STE 128, GLENDALE, AZ 85308-1252
(763) 639-1269
(602) 938-2283
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
06/25/2024
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