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General NPI Number Information
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NPI Number | 1184833782
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Entity Type | Individual
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Provider Name | JULIA MARIE PURTEE
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 801 S POWER RD SUITE 112
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City | MESA
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State | AZ
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Zip | 85206-5207
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Country | US
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Telephone | 480-641-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 6454 E UNIVERSITY DR #28
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City | MESA
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State | AZ
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Zip | 85205-7623
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Country | US
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Telephone | 480-516-5366
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MT08058
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License Number State | AZ
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