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Individual

MIKAYLA KOOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7301 E 2ND ST STE 206, SCOTTSDALE, AZ 85251-5610
(602) 761-7819
Mailing address
4422 N 75TH ST UNIT 6003, SCOTTSDALE, AZ 85251-4079
(480) 406-5797

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
297582
AZ
207X00000X
Orthopaedic Surgery Physician
297582
AZ

Other

Enumeration date
09/25/2023
Last updated
09/25/2023
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