Organization
EASTERN ARIZONA ORTHOPEDIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY TERESA ACOSTA (OFFICE MANAGER)
(928) 425-3193
Entity
Organization
Contact information
Practice address
5860 S HOSPITAL DR, STE103, GLOBE, AZ 85501-9449
(928) 425-3193
(928) 425-4771
Mailing address
5860 S HOSPITAL DR, STE 103, GLOBE, AZ 85501-9449
(928) 425-3193
(928) 425-4771
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11804
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235102
—
AZ
Enumeration date
04/24/2007
Last updated
06/12/2008
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