Individual
ALISON DOMENICA KITZEROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
Mailing address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
(602) 508-4830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AZ 2038
AZ
152W00000X
Optometrist
OPT002755
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2038
AZ MEDICAL LICENSE
AZ
01
—
OPT002755
GA OPTOMETRY LICENSE
GA
Enumeration date
07/02/2013
Last updated
02/19/2016
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