Individual
ADEWUSI SAMSON KESHINRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
64 E BROADWAY RD STE 200, TEMPE, AZ 85282-1377
(215) 294-0792
Mailing address
64 E BROADWAY RD STE 200, TEMPE, AZ 85282-1377
(215) 294-0792
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP053643
AZ
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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