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Impactmedical, Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
IMPACTMEDICAL, LLC17903876942020-11-15
Entity TypeOrganization
Provider OrganizationIMPACTMEDICAL, LLC
Practice Office Address701 W GLENDALE AVE
PHOENIX, AZ US
Practice Office Telephone6027621128
Mailing Address7000 N 16TH ST STE 102-201
PHOENIX, AZ 850205512 US
Business Telephone6027621128
Authorized OfficialMATTHEW COEN, DIRECTOR
6027621128
HPT Codes
CodeLicense NoState
261QM1300X PRIMARY
261QR0400X
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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