Individual
IVETTE T. DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2242 W WETHERSFIELD RD, PHOENIX, AZ 85029-2713
(623) 806-2831
Mailing address
2242 W WETHERSFIELD RD, PHOENIX, AZ 85029-2713
(623) 806-2831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2350-P.A.
PR
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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