Individual
THERESA GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 N 58TH AVE, GLENDALE, AZ 85301-1893
(623) 237-4210
Mailing address
PO BOX 930, BLACK CANYON CITY, AZ 85324-0930
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN073387
AZ
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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