Individual
JOEY NICKOLAS BETTENCOURT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
14002 N 49TH AVE UNIT 1118, GLENDALE, AZ 85306-4940
(209) 204-0827
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AZ
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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