American Geriatric Enterprise, Inc.

NPI #1841397072 in Hereford, Arizona

Provider Information

NPI Number: 1841397072
Entity Type: Organization
Organization Name: American Geriatric Enterprise, Inc.
Primary Specialty: Specialist
Enumeration Date: Sep 20, 2006
Last Updated: Oct 18, 2007

Practice Location

Address: 6164 S HIGHWAY 92
City: Hereford
State: Arizona
ZIP Code: 85615-9283
Phone: (520) 803-1108

Authorized Official

Name: DR. MONICA R VANDIVORT, M.D.
Title: OWNER
Phone: (520) 803-1108

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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