Organization
PS PRO IOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHALLEN WAYCHOFF III (COO/MANAGER)
(480) 634-6400
Entity
Organization
Contact information
Practice address
3724 N 3RD ST STE 301, PHOENIX, AZ 85012-2035
(480) 634-6400
(480) 404-9649
Mailing address
3724 N 3RD ST STE 301, PHOENIX, AZ 85012-2035
(480) 634-6400
(480) 404-9649
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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