Organization
SURGICAL ASSISTANTS OF ARIZONA
Active
Organization
SURGICAL ASSISTANTS OF ARIZONA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ISMAIL ISMAIL (SURGICAL ASSISTANT)
(313) 778-4144
Entity
Organization
Contact information
Practice address
320 BUCCANEER LN, LAKE HAVASU CITY, AZ 86406-6945
(313) 778-4144
Mailing address
320 BUCCANEER LN, LAKE HAVASU CITY, AZ 86406-6945
(313) 778-4144
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
3932
MI
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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