Individual
ORA GHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6014 W AUGUSTA AVE, GLENDALE, AZ 85301-1234
(623) 393-9626
Mailing address
6014 W AUGUSTA AVE, GLENDALE, AZ 85301-1234
(623) 393-9626
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84-2697163
HOME HEALTH CARE
—
Enumeration date
07/21/2021
Last updated
07/21/2021
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