COPPER STATE HOSPITAL AND SURGICAL
Nursing at Carriage Ln, Mesa, AZ

License number
Arizona 5596
Category
Nursing
Type
Surgical
Owner
Name: MR. JAMES HERZOG CSA
Title: OWNER
Phone: (480) 706-9430
Address
Address
2852 S Carriage Ln, Mesa, AZ 85202
National Provider ID: 1154746865
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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COPPER STATE HOSPITAL AND SURGICAL SERVICES LLC

2852 S Carriage Ln, Mesa, AZ 85202

Registration:
Feb 18, 2014
State ID:
L-1905863-0
Expiration:
Perpetual
Members:
James Herzog (Member), 2852 S Carriage Ln, Mesa, AZ 85202 (Physical),Caryn Lee (Member), 2852 S Carriage Ln, Mesa, AZ 85202 (Physical)

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