Organization
CTHVAMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LYNN GHIDOTTI COTA/L (COTA)
(602) 277-5551
Entity
Organization
Contact information
Practice address
239 W UTOPIA RD, PHOENIX, AZ 85027-4738
(602) 277-5551
Mailing address
239 W UTOPIA RD, PHOENIX, AZ 85027-4738
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
4023
AZ
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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