Individual
KELVIN LAMAR OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5501 N 19TH AVE STE 215, PHOENIX, AZ 85015-2450
(480) 409-0963
Mailing address
5501 N 19TH AVE STE 215, PHOENIX, AZ 85015-2450
(480) 409-0963
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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