Individual
DR. RUSTOM ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1968 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5729
(480) 703-4227
Mailing address
1968 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5729
(480) 703-4227
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
778154
AZ
174H00000X
Health Educator
778154
AZ
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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