Individual
KEVIN S GLIDEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2041 E 3RD DR, MESA, AZ 85204-1401
(480) 203-6855
(480) 900-8853
Mailing address
2041 E 3RD DR, MESA, AZ 85204-1401
(480) 203-6855
(480) 900-8853
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
03D2197602
AZ
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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