Provider Demographics
NPI:1609527852
Name:EMC WALK-IN AND WELLNESS INC.
Entity Type:Organization
Organization Name:EMC WALK-IN AND WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP-C/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAZELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-683-3257
Mailing Address - Street 1:1717 E BELL RD STE 8
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-6200
Mailing Address - Country:US
Mailing Address - Phone:602-546-7122
Mailing Address - Fax:
Practice Address - Street 1:1717 E BELL RD STE 8
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6200
Practice Address - Country:US
Practice Address - Phone:602-546-7122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty