Organization
FOOTHILLS BLVD CLINIC LLC
Active
Other names
Foothills Blvd Clinic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STAMATIA FISSAS GOCKEL DO (OWNER/PHYSICIAN)
(928) 342-1814
Entity
Organization
Contact information
Practice address
11611 S FOOTHILLS BLVD, SUITE C, YUMA, AZ 85367
(928) 342-1814
(928) 342-6154
Mailing address
11611 S FOOTHILLS BLVD, SUITE C, YUMA, AZ 85367
(928) 342-1814
(928) 342-6154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
02/03/2012
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