Individual
RYAN LAUSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5555 W THUNDERBIRD RD, GLENDALE, AZ 85306-4622
(602) 865-5555
Mailing address
5555 W THUNDERBIRD RD, GLENDALE, AZ 85306-4622
(602) 865-5555
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R3539
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2014
Last updated
12/20/2022
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