EJERZAIN ANILES- RENOVA

PHOENIX, AZ
NPI1053873109
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: AZ  7602)
Enumeration Date2019-04-05
Last Update Date2020-10-20
Business Address
Mr. EJERZAIN ANILES- RENOVA
435 N 5TH ST
PHOENIX, AZ 85004-2157
Phone number: 602-515-5001
Mailing Address
Mr. EJERZAIN ANILES- RENOVA
219 W PIEDMONT RD
PHOENIX, AZ 85041-8846
Phone number: 602-515-5001