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1023582376
MANNIX ISAIAS CONSOLACION
TUCSON, AZ
NPI
1023582376
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ 220791)
Enumeration Date
2019-01-18
Last Update Date
2021-07-06
Business Address
Mr. MANNIX ISAIAS CONSOLACION FNP
5475 S BRAIDED WASH DR
TUCSON, AZ 85747-6094
Phone number: 520-576-0348
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Mailing Address
Mr. MANNIX ISAIAS CONSOLACION FNP
2732 N ALVERNON WAY
TUCSON, AZ 85712-1804
Phone number: 520-382-3330
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