Individual
SIREESHA NALLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 S WILLARD ST, COTTONWOOD, AZ 86326-4126
(928) 634-5551
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
301413
NY
207Q00000X
Family Medicine Physician
Primary
72894
AZ
Other
Enumeration date
08/15/2016
Last updated
11/04/2024
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