| Pro Iom LLC | |
|
3329 E Bell Rd Ste A2-a5 Phoenix AZ 85032-2756 | |
| (602) 482-2282 | |
| Not Available |
| Full Name | Pro Iom LLC |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 3329 E Bell Rd Ste A2-a5, Phoenix, Arizona |
| Authorized Official Name and Position | Pierce W Waychoff (SOLE MBR) |
| Authorized Official Contact | 6024822282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Iom LLC 2801 Centerville Rd First Floor Pmb #711 Wilmington DE 19808-1609 | Pro Iom LLC 3329 E Bell Rd Ste A2-a5 Phoenix AZ 85032-2756 Ph: (602) 482-2282 |
| NPI Number | 1003432279 |
|---|---|
| Provider Enumeration Date | 06/23/2020 |
| Last Update Date | 07/22/2020 |
| Certification Date | 07/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003432279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | () | Primary |
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