Individual
JAMIE WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2929 E FILLMORE ST, PHOENIX, AZ 85008-6159
(602) 683-2400
(602) 275-8677
Mailing address
4215 NORTH 161ST AVE, GOODYEAR, AZ 85338
(602) 717-0747
(623) 242-6949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2986
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
591554
—
AZ
Enumeration date
01/08/2007
Last updated
07/08/2007
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