Organization
PODIATRY MATRIX LLC
Active
Organization
PODIATRY MATRIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL BROWER (MANAGER)
(623) 547-2800
Entity
Organization
Contact information
Practice address
13065 W MCDOWELL RD STE C101, AVONDALE, AZ 85392-6445
(928) 499-4519
Mailing address
2801 CENTERVILLE ROAD, PMB 690, WILMINGTON, DE 19808
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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