Search › Arizona › 106S00000X
Divon Davis-Boddie
NPI 1164274940 · on the registry since 2024
Practice
- Address
- 18330 N 79th Ave
Glendale, AZ 85308 - Phone
- (907) 378-0463
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- AK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-04-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona