LAKE HAVASU OB/GYN, PC
Ambulatory Health at Riviera Dr, Lake Havasu City, AZ

License number
Arizona 3696
Category
Ambulatory Health
Type
Medical Specialty
License number
Arizona 20A8265
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: DR. MARY JO VITA URSO D.O.
Title: OWNER
Phone: (928) 680-2846
Address
Address
99 Riviera Dr, Lake Havasu City, AZ 86403
National Provider ID: 1598944811
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Mary Jo Urso DO

99 Riviera Dr, Lake Havasu City, AZ 86403

Status:
Inactive
Industry:
Medical Doctor's Clinic
Doing business as:
Lake Havasu Ob/Gyn, PC<br>Mary Jo V. Urso, D.O
Inactive reason:
Ad-dissolved-file annual report
Registration:
Sep 8, 2003
Inactive since:
Feb 15, 2013
Phone:
(928) 680-2846 (Phone)
State ID:
-1093750-7
Expiration:
PERPETUAL
Directors:
Mary J. Urso (Osteopathy, Chief Executive Officer),Mary Lou Callerame (Manager),Susie Johannes (Real Estate Agent),...
Agent:
Mary Jo Urso,1995 Chip Dr, Lake Havasu City, AZ 86406 (Physical)

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