Individual
DEEADRA LYNANIA URSIN-ZACHARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRANIAL PROTHESIS
Contact information
Practice address
2707 S WHITE MOUNTAIN RD STE G, SHOW LOW, AZ 85901-7343
(928) 421-0998
Mailing address
1867 RAINBOW CIR, SHOW LOW, AZ 85901-7020
(928) 200-3131
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
AZ
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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