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Individual

MS. DETRA L VANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1729 E CALDWELL ST, PHOENIX, AZ 85042-8044
(602) 348-8278
Mailing address
1729 E CALDWELL ST, PHOENIX, AZ 85042-8044
(602) 348-8278

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
999950215
AZ

Other

Enumeration date
04/24/2024
Last updated
04/24/2024
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