Individual
CHARLES W CREELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
40387 W COLTIN WAY, MARICOPA, AZ 85138-6675
(480) 388-5631
Mailing address
40387 W COLTIN WAY, MARICOPA, AZ 85138-6675
(480) 388-5631
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
20409
AZ
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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