Organization
PHOENIX VA HEALTH CARE SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIE GUAN (REGISTERED DIETITIAN)
(305) 277-5551
Entity
Organization
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
15231 N 66TH DR, GLENDALE, AZ 85306-3117
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
1082914
AZ
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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