Organization
EXTREMITY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN D WALKER (MANAGING DIRECTOR)
(602) 405-5105
Entity
Organization
Contact information
Practice address
1601 N 9TH AVE, PHOENIX, AZ 85007-1707
(602) 405-5105
(602) 391-2110
Mailing address
1601 N 9TH AVE, PHOENIX, AZ 85007-1707
(602) 405-5105
(602) 391-2110
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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