Individual
CASEY DANELE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 N 58TH AVE, GLENDALE, AZ 85301-1867
(623) 237-4110
(623) 237-4115
Mailing address
7301 N 58TH AVE, GLENDALE, AZ 85301-1867
(623) 237-4110
(623) 237-4115
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
LP047299
AZ
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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