Organization
INNOVATIVE FAMILY HEALTH PRACTICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE DE JESUS (OWNER)
(480) 892-7000
Entity
Organization
Contact information
Practice address
4135 S POWER RD STE 120, MESA, AZ 85212-3626
(480) 892-7000
(480) 545-7001
Mailing address
4135 S POWER RD STE 120, MESA, AZ 85212-3626
(480) 892-7000
(480) 545-7001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
01/14/2020
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