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1699414870
JASON BANUELOS
PHOENIX, AZ
NPI
1699414870
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AZ 9366)
Enumeration Date
2022-06-03
Last Update Date
2023-12-12
Business Address
JASON BANUELOS PA
435 N 5TH ST
PHOENIX, AZ 85004-2157
Phone number: 602-827-2450
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Mailing Address
JASON BANUELOS PA
12217 N 129TH DR
EL MIRAGE, AZ 85335-6270
Phone number: 623-414-8631
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