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James Jarvise

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NPI Number Detailed Information

Provider Information:

Name: James Jarvise
Gender: M
Provider License Number If Given: 2586

NPI Information:

NPI: 1316940356
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 3725 E DERRINGER WAY
Gilbert, AZ 85297
Phone Number: 4808122119
Fax Number:

Provider Business Practice Location Address:

Address: 1455 W CHANDLER BLVD BLDG A SUITE 4
Chandler, AZ 85224
Phone Number: 4828992900
Fax Number: 4808990681

Provider Taxonomy:

Primary: 363A00000X
Secondary (if any):
State: AZ

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