Provider Demographics
NPI:1982952024
Name:URBAN LIVESTOCK & EQUINE VETERINARY SERVICES
Entity type:Organization
Organization Name:URBAN LIVESTOCK & EQUINE VETERINARY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:480-436-4970
Mailing Address - Street 1:744 N CENTER ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5084
Mailing Address - Country:US
Mailing Address - Phone:480-436-4970
Mailing Address - Fax:480-284-5045
Practice Address - Street 1:744 N CENTER ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5084
Practice Address - Country:US
Practice Address - Phone:480-436-4970
Practice Address - Fax:480-284-5045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6252174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty