Organization
NEW LIFE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT R KORN DO (MEDICAL DIRECTOR)
(480) 354-9700
Entity
Organization
Contact information
Practice address
2915 E BASELINE RD STE 105, GILBERT, AZ 85234-2427
(480) 354-6700
(480) 354-6708
Mailing address
2915 E BASELINE RD STE 105, GILBERT, AZ 85234-2427
(480) 354-6700
(480) 354-6708
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
109213
AZ
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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