Individual
KYLE JERVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13677 W MCDOWELL RD # AZ85395, GOODYEAR, AZ 85395-2635
(623) 882-1500
Mailing address
19947 W RANCHO DR, LITCHFIELD PARK, AZ 85340-2667
(602) 740-0131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7195
AZ
363A00000X
Physician Assistant
C06468
MD
Other
Enumeration date
04/21/2017
Last updated
06/09/2023
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