Organization · Type 2 NPI
Banner Physician Super Specialists Arizona LLC
Nutrition Education Nutritionist · Mesa, AZ
NPI number
1790337665
Active
Practice location
1450 S Dobson Rd Ste B221
Mesa, AZ 85202-4745
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nutrition Education Nutritionist Primary | 133NN1002X | None listed |
| Multi-Specialty Clinic/Center | 261QM1300X | None listed |
Nutrition Education Nutritionist: Definition to come...
Another provider at this address
About NPI 1790337665
Banner Physician Super Specialists Arizona LLC's National Provider Identifier is 1790337665, issued on Jul 11, 2019. The primary taxonomy on file is Nutrition Education Nutritionist (133NN1002X), and the practice location is in Mesa, AZ. The record was last updated on Dec 28, 2021.