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Individual

JONATHAN DALE HALLEY-IBRAHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9321 W THOMAS RD STE 202, PHOENIX, AZ 85037-3392
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(669) 742-6738
(669) 392-6738

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5792
AZ
363A00000X
Physician Assistant

Other

Enumeration date
09/10/2014
Last updated
02/20/2024
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