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RIDGE GLEN SPACKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
14502 W MEEKER BLVD, SUN CITY WEST, AZ 85375-5282
(623) 524-4000
Mailing address
3250 N 375 E, REXBURG, ID 83440-3437
(208) 313-4859

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
323408
AZ

Other

Enumeration date
05/30/2025
Last updated
06/17/2025
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