Graduated: 2024
NPI: 1508697608
Practice Locations (2)
PONDEROSA FAMILY CARE LLC
708 S COEUR D ALENE LN
PAYSON, AZ 855415662
9284688603
PONDEROSA FAMILY CARE LLC
806 S PONDEROSA ST
PAYSON, AZ 855415541
9284688603
Source: CMS National Downloadable File, September 2026.