Organization
SANANDO INTEGRATIVE MED CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA GONZALEZ RUIZ PA (CEO)
(928) 388-5473
Entity
Organization
Contact information
Practice address
2000 E. CESAR CHAVEZ BLVD, SAN LUIS, AZ 85336
(928) 388-5473
Mailing address
PO BOX 430, SAN LUIS, AZ 85349-0430
(928) 388-5473
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
03/08/2022
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