NATURAL MEDICINE AND DETOX INC.
Ambulatory Health at Roosevelt St, Phoenix, AZ

License number
Arizona 0680
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: MR. MARIO FONTES L.AC. CCH
Title: CLINIC DIRECTOR
Phone: (602) 307-0888
Address
Address
301 W Roosevelt St SUITE 2, Phoenix, AZ 85003
National Provider ID: 1700253507
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NATURAL MEDICINE AND DETOX, INC

301 W Roosevelt St STE 2, Phoenix, AZ 85003

Registration:
Jan 5, 2015
State ID:
-1974986-7
Expiration:
Perpetual
Directors:
Mario Fontes (Director), Director 301 W Roosevelt St STE 2, Phoenix, AZ 85003 (Physical),Malissa Stawicki (Director), Director 301 W Roosevelt St STE 2, Phoenix, AZ 85003 (Physical)

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