Individual
TAELYN DALLAS CARRIZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7550 N 19TH AVE STE 201, PHOENIX, AZ 85021-7976
(480) 963-1853
Mailing address
7550 N 19TH AVE STE 201, PHOENIX, AZ 85021-7976
(480) 963-1853
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6513
AZ
Other
Enumeration date
10/06/2016
Last updated
12/01/2016
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