Ketamine Wellness Centers Arizona LLC

NPI #1477935369 in Mesa, Arizona

Provider Information

NPI Number: 1477935369
Entity Type: Organization
Organization Name: Ketamine Wellness Centers Arizona LLC
Primary Specialty: Anesthesiology
Enumeration Date: Jun 26, 2015
Last Updated: Aug 21, 2020

Practice Location

Address: 113 W HOOVER AVE STE 101
City: Mesa
State: Arizona
ZIP Code: 85210-5214
Phone: (855) 538-9355

Authorized Official

Name: ANITA JERGER
Title: EXECUTIVE ASSISTANT
Phone: (855) 538-9355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychiatry & Neurology - Pain Medicine — Pain Medicine	2084P2900X
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X
Anesthesiology	207L00000X	Primary

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