NPI 1003492158

Clean Colonic Family Practice

Organisation Family Medicine Physician Phoenix, AZ

Practice location

Address: 4744 E Thunderbird Rd STE 4, Phoenix, AZ 85032-5577
Phone: (480) 269-5575

Authorised official

Name: Carolyn Berry
Title: Owner
Phone: (480) 269-5575

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Arizona →

Registry record

NPI: 1003492158
Entity type: Organization
NPI issued: 19 Mar 2021
Record last updated: 19 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.