Individual
MAKENNA C KROULIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5218 W TIERRA BUENA LN, GLENDALE, AZ 85306-2515
(623) 238-1387
Mailing address
5218 W TIERRA BUENA LN, GLENDALE, AZ 85306-2515
(623) 238-1387
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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