Individual
GWEN MOHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20814 N 17TH AVE, PHOENIX, AZ 85027-3518
(623) 760-4481
Mailing address
20814 N 17TH AVE, PHOENIX, AZ 85027-3518
(623) 760-4481
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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