Organization
PONDEROSA FAMILY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN P MICHELS MD (PHYSICIAN/OWNER)
(928) 468-8603
Entity
Organization
Contact information
Practice address
127 E MAIN ST STE D, PAYSON, AZ 85541-5646
(928) 468-8603
(928) 468-8625
Mailing address
PO BOX 2901, PAYSON, AZ 85547-2901
(928) 468-8603
(928) 468-8625
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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