Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 06-916 | AZ |
NPI | 1023174844 |
---|---|
Provider Name | Dr. Jennifer Amy Gentry-Calvo |
First Address | Anthem, AZ 85086-1490 |
Second Address | Anthem, AZ 85086-1490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 15/03/2008 |