INNOVATIVE PRIMARY CARE CLINIC OF HAVASU PLLC NPI 1588097349

NPI Information

INNOVATIVE PRIMARY CARE CLINIC OF HAVASU PLLC is a primary care nurse practitioner in Lake Havasu City, AZ. INNOVATIVE PRIMARY CARE CLINIC OF HAVASU PLLC NPI is 1588097349. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

297 LAKE HAVASU AVE S
SUITE 106
LAKE HAVASU CITY, AZ
ZIP 86403-526
Phone: (928) 854-7666
Fax: (928) 854-7660

The provider's authorized official is Jacquelyn J. Meyer .
The authorized official title is President and has the following contact phone number (928) 854-7666.

The enumeration date for this NPI number is 8/15/2013 and was last updated on 8/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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