Individual
IKIYA D RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6641 E BAYWOOD AVE STE B3, MESA, AZ 85206-1723
(602) 921-2562
Mailing address
6641 E BAYWOOD AVE STE B3, MESA, AZ 85206-1723
(602) 921-2562
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
02/08/2024
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