Individual
JENNIE ELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4600 S PARK AVE, TUCSON, AZ 85714-1697
(520) 889-9574
(520) 889-5072
Mailing address
8601 S 6TH AVENUE, TUCSON, AZ 85723-0001
(520) 792-1450
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
28560
AZ
Other
Enumeration date
03/20/2007
Last updated
10/04/2019
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