Organization
MEDISAGE, LLC
Active
Organization
MEDISAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M BONK LMT (OWNER/OPERATOR)
(623) 295-9001
Entity
Organization
Contact information
Practice address
5016 S ASH AVE, SUITE 105, TEMPE, AZ 85282-6845
(623) 295-9001
Mailing address
2602 N 87TH TER, SCOTTSDALE, AZ 85257-1844
(623) 295-9001
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-18159
AZ
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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