Individual
JASON JAY KEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15300 N COTTON LN, SURPRISE, AZ 85388-9613
(623) 584-8558
Mailing address
15300 N COTTON LN, SURPRISE, AZ 85388-9613
(623) 584-8558
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T069665
AZ
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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