Individual
MR. KYLE DENMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 453-0150
Mailing address
7640 E BARSTOW ST, MESA, AZ 85207-7523
(480) 219-6851
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2307
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
515827
—
AZ
Enumeration date
06/15/2006
Last updated
07/08/2007
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