Individual
LAUREN WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1300 N 12TH ST STE 301, PHOENIX, AZ 85006-2813
(602) 229-1999
Mailing address
1300 N 12TH ST STE 301, PHOENIX, AZ 85006-2813
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5435
AZ
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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