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Organization

DHHS IHS PHOENIX AREA

Active
Other names
Bylas Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHIRLEY M BONI (ADMINISTRATIVE OFFICER)
(928) 475-7348
Entity
Organization

Contact information

Practice address
HIGHWAY 70, MP 295.6, BYLAS, AZ 85530
(928) 475-2686
Mailing address
PO BOX 149, BYLAS, AZ 85530-0149
(928) 475-2686

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
152W00000X
Optometrist
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
363L00000X
Nurse Practitioner

Other

Enumeration date
10/16/2012
Last updated
10/16/2012
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