Organization
EAST VALLEY NEUROSURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FARRIS (CREDENTIALING SPECIALIST)
(480) 478-6620
Entity
Organization
Contact information
Practice address
2045 S VINEYARD, 142, MESA, AZ 85210-6889
(480) 303-6010
(480) 507-0019
Mailing address
2045 S VINEYARD, 142, MESA, AZ 85210-6889
(480) 303-6010
(480) 507-0019
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
10/29/2008
Last updated
09/13/2010
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