Organization
COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE FOWELL (CREDENTIALING MANAGER)
(520) 322-6274
Entity
Organization
Contact information
Practice address
2145 W 28TH ST STE B, YUMA, AZ 85364-1219
(928) 328-8338
(928) 328-8339
Mailing address
PO BOX 208313, DALLAS, TX 75320-8313
(520) 777-5030
(520) 509-4496
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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