Individual
MICHAEL VANCE FARNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17235 N 75TH AVE STE F100, GLENDALE, AZ 85308-0871
(480) 641-1165
Mailing address
5313 N ORO VISTA CT, LITCHFIELD PARK, AZ 85340-6305
(219) 221-3102
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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