Individual
DEVANTE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18540 W ONYX AVE, WADDELL, AZ 85355-4445
(602) 320-6498
Mailing address
18540 W ONYX AVE, WADDELL, AZ 85355-4445
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
AZ
Other
Enumeration date
05/18/2024
Last updated
05/18/2024
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