Individual
JERRY DON SANSTEAD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1063 N OPAL, MESA, AZ 85207-2275
(480) 205-9407
(480) 699-6413
Mailing address
14362 N FRANK LLOYD WRIGHT BLVD, SUITE B109, SCOTTSDALE, AZ 85260-8846
(602) 622-1934
(480) 699-6413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
883742
AZ
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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