Organization
METRO OTC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHALLEN WAYCHOFF III (COO/MANAGER)
(760) 486-9634
Entity
Organization
Contact information
Practice address
10046 N METRO PKWY W, SUITE 115, PHOENIX, AZ 85051
(602) 674-5515
(602) 674-3029
Mailing address
10046 N METRO PKWY W, SUITE 115, PHOENIX, AZ 85051-1437
(602) 674-5515
(602) 674-3029
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
08/09/2018
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