Individual
MR. RENE VENZON TICSAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
KAYENTA HEALTH CENTER HIGHWAY 160, KAYENTA, AZ 86033
(928) 697-4306
(928) 697-4107
Mailing address
15951 W COCOPAH ST, GOODYEAR, AZ 85338-7930
(928) 697-4306
(928) 697-4107
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
14256
AZ
2471C3402X
Radiography Radiologic Technologist
Primary
271815
MN
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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