Organization
CLINICA FAMILIAR BELLA VISTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILL INNOCENT M.D (OWNER)
(602) 423-8961
Entity
Organization
Contact information
Practice address
515 W BUCKEYE RD, STE 303, PHOENIX, AZ 85003-2647
(602) 423-8956
Mailing address
PO BOX 10176, GLENDALE, AZ 85318-0176
(602) 423-8961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32113
AZ
Other
Enumeration date
07/10/2007
Last updated
07/15/2015
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