Individual
LISSETTE RUIZ IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 W WATKINS RD, PHOENIX, AZ 85003-2830
(602) 254-3338
Mailing address
420 W. WATCKINS RD, PHOENIX, AZ 85003
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
07/01/2020
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