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Individual

MCKENZI FARAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
5853 E JASMINE ST, MESA, AZ 85205-3509
(480) 227-9463

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
11146
AZ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/24/2025
Last updated
08/14/2025
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