Individual
JACQUELYN LEAH GARRETT ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
682 W. SCHOOL BUS LANE, SNOWFLAKE, AZ 85937-5262
(928) 607-7831
Mailing address
682 W. SCHOOL BUS LANE, SNOWFLAKE, AZ 85937-5262
(928) 536-4156
(928) 536-2634
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5983
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
877516
AHCCCS
AZ
Enumeration date
07/02/2007
Last updated
08/18/2008
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