SearchArizona2355S0801X

Codye Boutin

NPI 1316599277 · on the registry since 2019 · sole proprietor

Practice

Address
5117 W Pershing Ave
Glendale, AZ 85304
Phone
(623) 628-2776

Registry record

Primary taxonomy
2355S0801X
2355S0801X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2019-07-11

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