Individual
DELICK MUTABAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9159 W GLENROSA AVE, PHOENIX, AZ 85037-0812
(240) 491-6773
Mailing address
9159 W GLENROSA AVE, PHOENIX, AZ 85037-0812
(240) 491-6773
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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