Individual
TIMOTHY PAVLAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5133 W FAWN DR, LAVEEN, AZ 85339-2898
(602) 710-7166
(602) 441-2553
Mailing address
5133 W FAWN DR, LAVEEN, AZ 85339-2898
(602) 710-7166
(602) 441-2553
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL8784H
AZ
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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