Individual
JENNIFER HALVORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1491 N ARIZONA BLVD STE 109, COOLIDGE, AZ 85128-3261
(520) 424-2222
Mailing address
1356 W WEATHERBY WAY, CHANDLER, AZ 85286-7065
(651) 253-0227
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10457A
AZ
Other
Enumeration date
05/23/2014
Last updated
05/23/2014
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