Organization
FAMILY FIRST VISION CARE ARIZONA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE JANDERNAL (CREDENTIALING MANAGER)
(732) 236-7067
Entity
Organization
Contact information
Practice address
21001 N TATUM BLVD STE 18, PHOENIX, AZ 85050-4207
(480) 513-4184
(480) 513-4184
Mailing address
4680 PARKWAY DR STE 22, MASON, OH 45040-8296
(513) 445-9064
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
01/31/2023
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