Individual
MR. KENNETH LUBOWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5035 N 39TH DR, PHOENIX, AZ 85019-2849
(747) 262-9196
Mailing address
5035 N 39TH DR, PHOENIX, AZ 85019-2849
(480) 743-0983
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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