Individual
DAVID MEDANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11980 W SHIFTING SANDS DR, PEORIA, AZ 85383-2623
(602) 721-5218
Mailing address
11980 W SHIFTING SANDS DR, PEORIA, AZ 85383-2623
(602) 721-5218
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2083B002X
TAXONOMY
—
Enumeration date
02/18/2019
Last updated
02/18/2019
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