Individual
SOFIA ELIZABETH LARREABETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11441 N 55TH AVE, GLENDALE, AZ 85304-3402
(623) 412-4603
Mailing address
15005 W CROCUS DR, SURPRISE, AZ 85379-6044
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
278643
AZ
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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