Individual
DR. JONATHON FENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
13828 W WADDELL RD, SURPRISE, AZ 85379-3802
(623) 476-1811
Mailing address
3745 W CAROL ANN WAY, PHOENIX, AZ 85053-3740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S021305
AZ
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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