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Organization
VIDADYNE HEALTHCARE LLC
Active
Organization
VIDADYNE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WILLIAM JENNER M.D. (ADMINISTRATOR)
(480) 201-6167
Entity
Organization
Contact information
Practice address
14820 N CAVE CREEK RD, STE 2, PHOENIX, AZ 85032-4953
(480) 646-3478
(480) 712-4695
Mailing address
14820 N CAVE CREEK RD, STE 2, PHOENIX, AZ 85032-4953
(480) 646-3478
(480) 712-4695
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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