Provider Demographics
NPI:1306627237
Name:ZYNERGY SKIN & MED SPA LLC
Entity type:Organization
Organization Name:ZYNERGY SKIN & MED SPA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:855-625-7546
Mailing Address - Street 1:1910 S STAPLEY DR STE 127
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-6676
Mailing Address - Country:US
Mailing Address - Phone:480-914-3376
Mailing Address - Fax:480-914-3377
Practice Address - Street 1:1910 S STAPLEY DR STE 127
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6676
Practice Address - Country:US
Practice Address - Phone:480-914-3376
Practice Address - Fax:480-914-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty