OrganizationActive
Banner Physician Specialists Arizona LLC
NPI 1326710906 · Nutrition Education Nutritionist · Peoria, AZ
Provider details
- NPI number
- 1326710906
- Entity type
- Organization
- Primary specialty
- Nutrition Education NutritionistDietary & Nutritional Service Providers
- Parent organization
- Banner Medical Group
- Organization subpart
- Yes
- Authorized official
- Dennis Laraway, Chief Financial Officer(602) 747-4000
Specialties & taxonomies
Dietary & Nutritional Service Providers
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Practice location
9165 W Thunderbird Rd
Peoria, AZ 85381-4847
Phone: (623) 285-1120
Fax: (623) 285-2626
Approximate (ZIP-level) locationGet directions
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Registry dates
- Enumerated
- 2021-10-01
- Last updated
- 2021-12-29
- Certified
- 2021-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.