Organization
BREAST INK PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL WARD (OWNER)
(480) 636-6015
Entity
Organization
Contact information
Practice address
2321 S ALTA VISTA CIR, MESA, AZ 85202-6474
(480) 636-6015
Mailing address
2321 S ALTA VISTA CIR, MESA, AZ 85202-6474
(480) 636-6015
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/28/2014
Last updated
09/28/2014
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