Individual
JENNIFER LILIANA AVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2330 N 75TH AVE STE 101, PHOENIX, AZ 85035-1200
(623) 703-7690
Mailing address
19341 W SELDON LN, WADDELL, AZ 85355-9904
(623) 703-7690
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002705
AZ
Other
Enumeration date
06/06/2023
Last updated
06/13/2023
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