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General NPI Number Information
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NPI Number | 1326239732
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Entity Type | Individual
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Provider Name | JOBETH C. MINKS B.S.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 483 W. SEED FARM ROAD
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City | SACATON
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State | AZ
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Zip | 85147
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Country | US
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Telephone | 602-528-1200
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Fax | 602-271-7870
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Provider Business Mailing Address
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Address Line | 6811 E SUPERSTITION SPRINGS BLVD
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City | MESA
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State | AZ
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Zip | 85209-4001
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Country | US
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Telephone | 480-641-4051
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 678993
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License Number State | AZ
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