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1013405497
BENJMAMIN THOMAS CARLSON
PHOENIX, AZ
NPI
1013405497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2080P0008X Pediatrics, Neurodevelopmental Disabilities
(Licence: AZ 13747)
Enumeration Date
2018-05-01
Last Update Date
2018-05-01
Business Address
BENJMAMIN THOMAS CARLSON PTA
5314 N 7TH ST
PHOENIX, AZ 85014-2805
Phone number: 602-277-5006
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Mailing Address
BENJMAMIN THOMAS CARLSON PTA
1157 E WATSON DR
TEMPE, AZ 85283-3034
Phone number:
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