Organization
SOUTHWEST EAR, NOSE & THROAT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PRATER MD (OWNER / MEMBER MANAGER)
(928) 453-0303
Entity
Organization
Contact information
Practice address
1760 MCCULLOCH BLVD N STE 102, LAKE HAVASU CITY, AZ 86403-6559
(928) 453-0303
(928) 453-0338
Mailing address
1760 MCCULLOCH BLVD N STE 102, LAKE HAVASU CITY, AZ 86403-6559
(928) 453-0303
(928) 453-0338
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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