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Individual

BRIAN H ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2919 S ELLSWORTH RD, SUITE 124, MESA, AZ 85212-2167
(480) 633-7944
(480) 633-0255
Mailing address
PO BOX 9058, MESA, AZ 85214-9058
(480) 609-9300
(480) 609-9350

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0622
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
971079
AZ
Enumeration date
08/22/2005
Last updated
01/03/2013
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