Individual
DONALD LAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2560 E MOBILE LN, PHOENIX, AZ 85040-2644
(602) 283-4303
Mailing address
2560 E MOBILE LN, PHOENIX, AZ 85040-2644
(602) 283-4303
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
317334
AZ
Other
Enumeration date
09/14/2007
Last updated
12/13/2007
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