Individual
MRS. RENEE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
697 S AZURE DRIVE, CAMP VERDE, AZ 86322-7281
(928) 567-3177
Mailing address
PO BOX 2983, COTTONWOOD, AZ 86326-2587
(928) 567-3177
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062697
AHCCCS
AZ
Enumeration date
11/29/2006
Last updated
07/08/2007
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