Individual
DAISY HANNAH LILJENQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2919 S ELLSWORTH RD STE 102, MESA, AZ 85212-2165
(480) 404-1776
Mailing address
1331 W BASELINE RD UNIT 230, MESA, AZ 85202-5879
(731) 334-3402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8371
AZ
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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