Individual
ALIE RIAD JREISAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2202 N STOCKTON HILL RD STE 101, KINGMAN, AZ 86401-4622
(928) 757-2101
Mailing address
734 COUNTRY CLUB DR, KINGMAN, AZ 86401-3971
(708) 466-2700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R78878
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/08/2021
Last updated
06/22/2021
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