Individual
LARI MICHELLE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1125 E SOUTHERN AVE, SUITE 300, MESA, AZ 85204-5045
(480) 545-8119
(480) 892-6805
Mailing address
1201 S ALMA SCHOOL RD, SUITE 14000, MESA, AZ 85210-2008
(480) 545-8119
(480) 892-6805
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
26551
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
436502
—
AZ
Enumeration date
10/14/2005
Last updated
10/26/2016
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