Organization
JMM VENTURES
Active
Other names
ty witt md
Organization subpart
No
Provider details
NPI number
Authorized official
TY WITT MD (PHYSICIAN)
(623) 412-2229
Entity
Organization
Contact information
Practice address
5310 W THUNDERBIRD RD, STE 308, GLENDALE, AZ 85306
(623) 412-2229
(602) 314-6662
Mailing address
5310 W THUNDERBIRD RD, STE 308, GLENDALE, AZ 85306
(623) 412-2229
(602) 314-6662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30147
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467444828
NPI
AZ
Enumeration date
03/22/2011
Last updated
03/22/2011
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