Individual
MRS. PAMELA DENISE MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11120 W VAN BUREN ST APT 2117, AVONDALE, AZ 85323-7304
(602) 243-1773
(602) 276-1984
Mailing address
11120 W VAN BUREN ST APT 2117, AVONDALE, AZ 85323-7304
(602) 243-1773
(602) 276-1984
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
4866156
AZ
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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