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Organization
MAYNE MEDICAL, LLC
Active
Organization
MAYNE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNELLE SUAREZ PA-C (OWNER, PA, RENDERING PROVIDER)
(480) 688-3321
Entity
Organization
Contact information
Practice address
4524 N MARYVALE PKWY STE 160, PHOENIX, AZ 85031-1739
(480) 688-3321
(480) 393-7197
Mailing address
10645 N TATUM BLVD STE C200464, PHOENIX, AZ 85028-0425
(480) 688-3321
(480) 393-7197
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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