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Organization

PRESTIGE INTERVENTIONAL GROUP, 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
3724 N 3RD ST, SUITE 302, PHOENIX, AZ 85012-2034
(602) 674-8185
(602) 674-8117
Mailing address
3724 N 3RD ST, SUITE 301, PHOENIX, AZ 85012-2034
(760) 486-9634
(480) 471-6315

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
03/09/2017
Last updated
03/09/2017
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