Organization
BANNER HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1432 S DOBSON RD STE 402, MESA, AZ 85202-4777
(480) 412-5550
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2012
Last updated
12/28/2021
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