Organization
MOUNTAIN FAMILY CARE AND WALK IN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN SEAN SMITHSON M.D. (OWNER)
(928) 532-3926
Entity
Organization
Contact information
Practice address
320 E DEUCE OF CLUBS, SHOW LOW, AZ 85901-4808
(928) 532-3926
(928) 367-4916
Mailing address
PO BOX 2680, SHOW LOW, AZ 85902-2680
(928) 532-3926
(928) 367-4916
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45758
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
711987
—
AZ
Enumeration date
08/14/2014
Last updated
08/14/2014
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