Individual
KENNETH VICKROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
222 W THOMAS RD STE 114, PHOENIX, AZ 85013-4420
(602) 406-4578
(602) 424-5445
Mailing address
222 W THOMAS RD STE 114, PHOENIX, AZ 85013-4420
(602) 406-4578
(602) 424-5445
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
AP8000
AZ
Other
Enumeration date
07/27/2015
Last updated
06/01/2021
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