Lone Wolf Medicine, INC

NPI #1053504225 in Payson, Arizona

Provider Information

NPI Number
1053504225
Entity Type
Organization
Organization Name
Lone Wolf Medicine, INC
Primary Specialty
Physician Assistant - Medical
Enumeration Date
Aug 21, 2007
Last Updated
Aug 21, 2007

Practice Location

Address
806 S PONDEROSA ST
City
Payson
State
Arizona
ZIP Code
85541-5541
Phone
(928) 474-6617

Authorized Official

Name
MARILYN F HERON, PAC
Title
PHYSICIAN ASSISITANT
Phone
(928) 474-6617

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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