NPI 1174660435

Banner Desert Medical Center

Organisation Prosthetic/Orthotic Supplier Mesa, AZ

Practice location

Address: 1400 S Dobson Rd Oncology Gift Shop, Room 1053, Mesa, AZ 85202-4707
Phone: (480) 412-5959
Mailing address: 2901 N Central Ave STE 160, Phoenix, AZ 85012-2702

Authorised official

Name: Dennis Laraway
Title: Cfo
Phone: (602) 747-4000

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

Other Prosthetic/Orthotic Supplier providers in Arizona →

Registry record

NPI: 1174660435
Entity type: Organization
NPI issued: 30 Jan 2007
Record last updated: 23 Dec 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.