Organization
NEURO FOCUS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALDECK CHARLES M.D. (CEO)
(602) 315-7033
Entity
Organization
Contact information
Practice address
1400 NORTH GILBERT ROAD, SUITE H, GILBERT, AZ 85234-2726
(480) 632-2301
(480) 813-4534
Mailing address
1400 NORTH GILBERT ROAD, SUITE H, GILBERT, AZ 85234-2726
(480) 632-2301
(480) 813-4534
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
33521
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
611096
—
AZ
Enumeration date
04/18/2011
Last updated
04/02/2012
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