Individual
RYAN HONOMICHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3120 W CAREFREE HWY STE B15, PHOENIX, AZ 85086-3201
(480) 608-5138
Mailing address
22729 N 102ND AVE, PEORIA, AZ 85383-2731
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
312082
AZ
Other
Enumeration date
08/02/2024
Last updated
08/19/2024
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