| Soulistic Medical Institute | |
|
26 Tubac Road Suite B Tubac AZ 85646 | |
| (520) 398-3970 | |
| (520) 398-2944 |
| Full Name | Soulistic Medical Institute |
|---|---|
| Speciality | Family Medicine |
| Location | 26 Tubac Road, Tubac, Arizona |
| Authorized Official Name and Position | Marayeh Cunningham (MANAGING DIRECTOR) |
| Authorized Official Contact | 5203983970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulistic Medical Institute Po Box 1990 Tubac AZ 85646-1990 Ph: (520) 398-3970 | Soulistic Medical Institute 26 Tubac Road Suite B Tubac AZ 85646 Ph: (520) 398-3970 |
| NPI Number | 1215986104 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 11/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215986104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3784 (Arizona) | Secondary |
| 207Q00000X | Family Medicine | 27940 (Arizona) | Primary |