Individual
KYLA MAE MCCALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5836 E HOLMES AVE, MESA, AZ 85206-6835
(480) 277-4438
Mailing address
5836 E HOLMES AVE, MESA, AZ 85206-6835
(480) 277-4438
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP042966
AZ
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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