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1003432667
JOHN HENRY MARTIN LICO
SURPRISE, AZ
NPI
1003432667
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
310400000X Assisted Living Facility
(Licence: AZ AL11496H)
Enumeration Date
2020-06-19
Last Update Date
2020-06-19
Business Address
JOHN HENRY MARTIN LICO
15244 W WATSON LN
SURPRISE, AZ 85379-7040
Phone number: 623-227-9697
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Mailing Address
JOHN HENRY MARTIN LICO
15244 W WATSON LN
SURPRISE, AZ 85379-7040
Phone number:
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