Individual
JEREMY BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CLINICIAN I
Contact information
Practice address
235 E RAY RD, APT 1083, CHANDLER, AZ 85225-3344
(602) 599-5575
(602) 599-5875
Mailing address
202 E EARLL DR, SUITE 200, PHOENIX, AZ 85012-2647
(602) 599-5404
(602) 599-5704
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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