Individual
WANDA G ICHIRIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4135 S POWER RD STE 113, MESA, AZ 85212-3625
(480) 626-2444
(480) 409-2987
Mailing address
PO BOX 88747, MILWAUKEE, WI 53288-5499
(480) 945-6777
(480) 481-5070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8561
AZ
Other
Enumeration date
03/23/2007
Last updated
11/21/2022
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