Provider Demographics
NPI:1821436890
Name:DIABETIC AND NEUROPATHY TREATMENT CENTERS II LLC
Entity Type:Organization
Organization Name:DIABETIC AND NEUROPATHY TREATMENT CENTERS II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:JOSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-760-8195
Mailing Address - Street 1:18731 N REEMS RD
Mailing Address - Street 2:#640
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8644
Mailing Address - Country:US
Mailing Address - Phone:623-544-5701
Mailing Address - Fax:
Practice Address - Street 1:18731 N REEMS RD
Practice Address - Street 2:#640
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8644
Practice Address - Country:US
Practice Address - Phone:623-544-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty