Individual
KYLE SANNIEC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9250 N 3RD ST STE 1003, PHOENIX, AZ 85020-2402
(602) 331-7811
Mailing address
9250 N 3RD ST STE 1003, PHOENIX, AZ 85020-2402
(602) 331-7811
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
60973
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2013
Last updated
07/17/2020
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