Individual
JAVIER PARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3202 W FOLGERS RD, PHOENIX, AZ 85027-7004
(623) 492-0790
Mailing address
8311 S 141ST AVE, GOODYEAR, AZ 85338-9250
(623) 492-0790
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PENDING
AZ
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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