Individual
JACOB MOLINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15820 N 21ST DR, PHOENIX, AZ 85023-7268
(602) 502-7738
Mailing address
15820 N 21ST DR, PHOENIX, AZ 85023-7268
(602) 502-7738
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
AZ
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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