Organization
PREMIUM ADVISORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY CARTER (OWNER)
(602) 317-1006
Entity
Organization
Contact information
Practice address
6314 SOUTH 54TH LANE, LAVEEN VILLAGE, AZ, USA, LAVEEN, AZ 85339
(602) 317-1006
Mailing address
6314 SOUTH 54TH LANE, LAVEEN VILLAGE, AZ, USA, LAVEEN, AZ 85339
(602) 317-1006
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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