| Clean Colonic Family Practice | |
|
4744 E Thunderbird Rd Ste 4 Phoenix AZ 85032-5577 | |
| (480) 269-5575 | |
| Not Available |
| Full Name | Clean Colonic Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 4744 E Thunderbird Rd Ste 4, Phoenix, Arizona |
| Authorized Official Name and Position | Carolyn Berry (OWNER) |
| Authorized Official Contact | 4802695575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clean Colonic Family Practice 4744 E Thunderbird Rd Ste 4 Phoenix AZ 85032-5577 Ph: (480) 269-5575 | Clean Colonic Family Practice 4744 E Thunderbird Rd Ste 4 Phoenix AZ 85032-5577 Ph: (480) 269-5575 |
| NPI Number | 1003492158 |
|---|---|
| Provider Enumeration Date | 03/19/2021 |
| Last Update Date | 03/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003492158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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