Organization
MOLLED TRAVEL VACCINES, PLLC
Active
Organization
MOLLED TRAVEL VACCINES, PLLC
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
(480) 646-9020
Entity
Organization
Contact information
Practice address
11811 N. TATUM BLVD, #P132, PHOENIX, AZ 85028-1614
(877) 358-8648
(877) 877-6875
Mailing address
668 N 44TH ST, SUITE 100W, PHOENIX, AZ 85008-6507
(877) 358-8648
(480) 546-3421
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
08/02/2022
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