Organization
PWC II
Active
Other names
Prescott Women's Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD M OHANESIAN M.D. (PARTNER)
(928) 778-4300
Entity
Organization
Contact information
Practice address
919 12TH PL, SUITE 1, PRESCOTT, AZ 86305-1433
(928) 778-4300
(928) 771-0920
Mailing address
919 12TH PL, SUITE 1, PRESCOTT, AZ 86305-1433
(928) 778-4300
(928) 771-0920
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
28766
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151770
—
AZ
Enumeration date
10/25/2006
Last updated
04/03/2012
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