Banner Physician Super Specialists Arizona LLC
Banner Physician Super Specialists Arizona LLC is a Nutrition Education Nutritionist in Mesa, Arizona. Registered with an NPI since 2019.
- In the registry since
- 2019
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1450 S Dobson Rd Ste B221Mesa, AZ 85202-4745
Phone: (480) 827-5370
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nutrition Education Nutritionist (primary) | Taxonomy 133NN1002X |
|---|---|
| Multi-Specialty Clinic/Center | Taxonomy 261QM1300X |
Record details
| NPI number | 1790337665 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Banner Health |
| Authorized official | Dennis Laraway — Cfo · (602) 747-4000 |
| NPI enumerated | July 11, 2019 |
| Last updated in NPPES | December 28, 2021 |
| Certification date | December 28, 2021 |
| Mailing address | 2901 N Central Ave Ste 160, Phoenix, AZ 85012-2702 |
Other providers in Mesa
-
William Bozeman, DHSC
4140 E Baseline Rd Ste 101, Mesa, AZ 85206-4413 · (505) 870-4949
-
Cassea Marie Herscheberg, NUTRITIONIST
3035 S Ellsworth Rd Ste 103, Mesa, AZ 85212-2136 · (480) 736-1777