Individual
MICA SOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 E OSBORN RD, PHOENIX, AZ 85018-5767
(602) 381-6140
Mailing address
3501 E OSBORN RD, PHOENIX, AZ 85018-5767
(602) 381-6140
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN174566
AZ
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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