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1093806762
KENNETH STEPHEN BISTRICKY
PHOENIX, AZ
NPI
1093806762
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207N00000X Dermatology
(Licence: AZ 8807)
Enumeration Date
2006-09-27
Last Update Date
2007-07-08
Business Address
Dr. KENNETH STEPHEN BISTRICKY M.D.
650 E INDIAN SCHOOL RD
PHOENIX, AZ 85012-1839
Phone number: 602-277-5551
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Mailing Address
Dr. KENNETH STEPHEN BISTRICKY M.D.
3391 E. CULLUMBER STREET
GILBERT, AZ 85234
Phone number: 602-277-5551
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