Individual
JAN PAUL ROA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9010 S PRIEST DR APT 1026, TEMPE, AZ 85284-1069
(602) 527-4426
Mailing address
9010 S PRIEST DR APT 1026, TEMPE, AZ 85284-1069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN232465
GA
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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