Provider Information for 1407006380
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JENNIFER L ENDERS MA
Sex: Female
NPI: 1407006380
Last Updated: 2015-04-06
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407006380 | ||||||||||||
| Enumeration Date | 2008-09-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1115 E FLORENCE BLVD CASA GRANDE, AZ 85122-4228 United States Phone: 480-320-8378 | Fax: | ||||||||||||
| Primary Practice Address | 1115 E FLORENCE BLVD CASA GRANDE, AZ 85122-4228 United States Phone: 480-320-8378 | Fax: | ||||||||||||
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