Individual
GWEN ARLA WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14421 N 23RD AVE, PHOENIX, AZ 85023-6023
(602) 347-2600
Mailing address
42011 N 7TH ST, DESERT HILLS, AZ 85086-7325
(623) 742-0313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0806
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
558710
—
AZ
Enumeration date
03/28/2007
Last updated
07/09/2007
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