Individual
MICHELLE DIOCAMPO CLARICIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12775 W BELL RD, SURPRISE, AZ 85378-9770
(623) 215-0082
Mailing address
12775 W BELL RD, SURPRISE, AZ 85378-9770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6346
AZ
363AM0700X
Medical Physician Assistant
25MP00270900
NJ
Other
Enumeration date
01/12/2012
Last updated
08/04/2016
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