Individual
KRISTI KRISTINE ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3933 EAST EDNA, SUITE 102, PHOENIX, AZ 85032
(602) 569-5437
(602) 482-4640
Mailing address
4605 SOUTH PRIEST DRIVE, LOT 291, TEMPE, AZ 85282
(480) 695-0469
(602) 482-4640
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3098
AZ
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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