Banner Medical Group Pediatric Sleep, LLC

NPI #1104416429 in Casa Grande, Arizona

Provider Information

NPI Number
1104416429
Entity Type
Organization
Organization Name
Banner Medical Group Pediatric Sleep, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
BANNER MEDICAL GROUP
Primary Specialty
Clinic/Center - Sleep Disorder Diagnostic
Enumeration Date
Jan 20, 2021
Last Updated
Dec 30, 2021

Practice Location

Address
1828 E FLORENCE BLVD BLDG C STE 136
State
Arizona
ZIP Code
85122
Phone
(520) 381-6282

Authorized Official

Name
DENNIS LARAWAY
Title
CFO
Phone
(602) 747-4000

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Sleep Disorder DiagnosticSleep Disorder Diagnostic

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