Most Relevant Information
Provider Data
| NPI Number: | 1003698143 |
| Provider Name: | JENNIE CASARA RUBIO |
| Entity Type: | Individual |
| Taxonomy Code: | 2355S0801X |
| Specialty: | Specialist/Technologist |
| License Number: | SLPA14589 |
Most Important Dates
| Enumeration Date: | 10/13/2023 |
| Last Updated: | 10/13/2023 |
Provider Practice Location
1909 E RAY RD STE 9-244
CHANDLER
AZ
852258724
Practice Location Phone/Fax
| Phone: | 4802962363 |
| Fax: |
Provider Mailing Location
7845 S 4TH AVE
PHOENIX
AZ
850418039
Provider Mailing Phone/Fax
| Phone: | 6027771623 |
| Fax: |