Organization
THE BRIDGE GROUP OF ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM WILLIS (CEO)
(928) 671-1750
Entity
Organization
Contact information
Practice address
1237 S VAL VISTA DR, MESA, AZ 85204-6401
(480) 776-3390
(480) 396-0532
Mailing address
1237 S VAL VISTA DR, MESA, AZ 85204-6401
(480) 776-3390
(480) 396-0532
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
163WG0000X
General Practice Registered Nurse
Primary
—
—
Other
Enumeration date
01/22/2015
Last updated
02/11/2015
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