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General NPI Number Information
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NPI Number | 1124278254
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Entity Type | Individual
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Provider Name | JANICE RENEE MORASCH PA
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Gender | Female
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 3645 SOUTH ROME STREET SUITE 204
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City | GILBERT
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State | AZ
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Zip | 85297
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Country | US
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Telephone | 480-857-0222
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Fax | 480-857-0020
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Provider Business Mailing Address
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Address Line | 2945 SOUTH DOBSON RD
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City | MESA
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State | AZ
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Zip | 85202
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Country | US
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Telephone | 480-857-0222
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Fax | 480-857-0020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3686
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License Number State | AZ
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