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Individual

DOROTHY RUTH GRANBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4220 N 20TH AVE, 100, PHOENIX, AZ 85015-5101
(602) 254-9701
(602) 252-0830
Mailing address
14602 N 19TH AVE, 148, PHOENIX, AZ 85023-7102
(480) 347-5702
(602) 252-0830

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
AZ

Other

Enumeration date
09/20/2013
Last updated
09/20/2013
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