Individual
CARRIE VAN SLYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20984 N LEONA BLVD, MARICOPA, AZ 85238-5508
(520) 450-2282
Mailing address
20984 N LEONA BLVD, MARICOPA, AZ 85238-5508
(520) 450-2282
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/27/2009
Last updated
08/27/2009
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