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JAMES BURRELL
>> Community/Behavioral Health >> AgenciesRegistrant NPI Number: 1164996484
Individual Registrant: JAMES BURRELL
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
854 S SUNSET AVE SOMERTON, AZ 85350-5005 US
Tel: 602-367-5345 Fax: 623-321-8145
Tel: 602-367-5345 Fax: 623-321-8145
Contact information for business:
4409 N 179TH DR GOODYEAR, AZ 85395-5201 US
Tel: 623-229-4755 Fax: 623-321-8145
Tel: 623-229-4755 Fax: 623-321-8145
Registration Information:
NPI: 1164996484
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 251S00000X | Agencies Community/Behavioral Health | AZ | BH5622 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
