Individual
JUSTIN FINYOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5002 E 23RD ST, TUCSON, AZ 85711-4916
(520) 203-7784
Mailing address
5002 E 23RD ST, TUCSON, AZ 85711-4916
(520) 203-7784
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-2515
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
921511
—
AZ
Enumeration date
11/21/2006
Last updated
07/09/2007
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