Organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Active
Parent organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Other names
Healthy Living Center/Diabetes Treatment & Prevention Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Authorized official
LYNETTE BONAR (CHIEF EXECUTIVE OFFICER)
(928) 283-2501
Entity
Organization
Contact information
Practice address
167 NORTH MAIN STREET, TUBA CITY, AZ 86045
(928) 283-2094
(928) 283-2677
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2094
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
200013
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721250
—
AZ
Enumeration date
02/20/2017
Last updated
02/20/2017
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