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Organization

AFC OF QUEEN CREEK, PLLC

Active
Parent organization
AFC OF QUEEN CREEK, PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
AFC OF QUEEN CREEK, PLLC
Authorized official
NATHALIE T. ALFONSO (MEDICAL DIRECTOR)
(480) 882-9105
Entity
Organization

Contact information

Practice address
85 W COMBS RD, SUITE 109, SAN TAN VALLEY, AZ 85140-9105
(480) 882-9105
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
AP4940
AZ

Other

Enumeration date
12/06/2013
Last updated
12/06/2013
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