Most Relevant Information
Provider Data
| NPI Number: | 1003378308 |
| Provider Name: | JONATHAN RAY DPM |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/04/2019 |
| Last Updated: | 04/25/2023 |
Provider Practice Location
5750 W THUNDERBIRD RD G700
GLENDALE
AZ
853064660
Practice Location Phone/Fax
| Phone: | 6029383600 |
| Fax: | 6029380400 |
Provider Mailing Location
5750 W THUNDERBIRD RD
G700
GLENDALE
AZ
853064691
Provider Mailing Phone/Fax
| Phone: | 6029383600 |
| Fax: | 6029380400 |