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Individual

MR. JESUS MORENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7534 N. 46TH CIR, GLENDALE, AZ 85301-1676
(623) 847-5821
Mailing address
1522 E.SOUTHERN AVE, PHOENIX, AZ 85040-3543
(602) 243-1773

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
AZ

Other

Enumeration date
04/13/2007
Last updated
07/26/2007
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