Individual
JENA HAVILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309-1529
(623) 856-9919
Mailing address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309-1529
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
008013
AZ
Other
Enumeration date
06/14/2016
Last updated
04/21/2023
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