Search › Arizona › 343900000X
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NPI 1033474960 · on the registry since 2012 · sole proprietor
Practice
- Address
- 3907 W Palo Verde Dr
Phoenix, AZ 85019 - Phone
- (602) 405-5500
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-07-06
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