Individual
GEORGE PREMPEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4512 W DONNER DR, LAVEEN, AZ 85339-4262
(602) 810-6976
Mailing address
4512 W DONNER DR, LAVEEN, AZ 85339-4262
(602) 518-4564
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D02611349
AZ
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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