Individual
KYLE FJERSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 885-8185
Mailing address
5418 W LONE STAR DR, TUCSON, AZ 85713-6733
(520) 403-5067
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/25/2014
Last updated
04/29/2014
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