Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | L13636212 | AZ |
NPI | 1003225608 |
---|---|
Provider Name | Mrs. Martha Reed |
First Address | Glendale, AZ 85308 |
Second Address | Glendale, AZ 85308-5674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2014 |
Last Update Date | 07/08/2014 |