Individual
MYRTHIL DIT JIMMY MOMPREMIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A
Contact information
Practice address
3140 N 35TH AVE STE 7, PHOENIX, AZ 85017-5270
(602) 353-6656
(602) 442-2065
Mailing address
3140 N 35TH AVE STE 7, PHOENIX, AZ 85017-5270
(602) 353-6656
(602) 442-2065
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9621
AZ
Other
Enumeration date
03/04/2021
Last updated
09/12/2025
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