Individual
MR. MARION WILSON MEMMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
980 E PECOS RD STE 3, CHANDLER, AZ 85225-2438
(480) 963-8800
Mailing address
19208 E APPLEBY RD, QUEEN CREEK, AZ 85142-9063
(480) 313-6413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2255
AZ
Other
Enumeration date
10/05/2006
Last updated
06/02/2020
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