Ponderosa Family Care, LLC

NPI #1144535626 in Payson, Arizona

Provider Information

NPI Number: 1144535626
Entity Type: Organization
Organization Name: Ponderosa Family Care, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Aug 9, 2010
Last Updated: Dec 5, 2014

Practice Location

Address: 806 S PONDEROSA ST
City: Payson
State: Arizona
ZIP Code: 85541-5541
Phone: (928) 468-8603

Authorized Official

Name: DR. ALAN P MICHELS
Title: PHYSICIAN
Phone: (928) 468-8603

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Internal Medicine	207R00000X	Primary

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