Individual
JOSE GRIEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4650 W. SWEETWATER, GLENDALE, AZ 85304-1505
(602) 347-2600
Mailing address
1201 E NORTHSHORE DR UNIT 224, TEMPE, AZ 85283-1401
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036269
—
AZ
Enumeration date
05/04/2007
Last updated
07/08/2007
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