Individual
MRS. CONSTANCE ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
440 N WASHINGTON AVE, PRESCOTT, AZ 86301-2642
(928) 443-1991
Mailing address
4525 W SIX CLAIMS RD, PRESCOTT, AZ 86305-7033
(928) 541-7649
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
900044
AZ
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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