Organization
LAY FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI LAY FNP-C (OWNER AND PROVIDER)
(602) 509-9177
Entity
Organization
Contact information
Practice address
4494 W PEORIA AVE STE 115A, GLENDALE, AZ 85302-2020
(602) 509-9177
(480) 666-6287
Mailing address
PO BOX 406, LAVEEN, AZ 85339-0406
(480) 431-5067
(480) 666-6287
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2019
Last updated
11/21/2019
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