INGRAM MALCOLM KERRY DIRTON

PHOENIX, AZ
NPI1275302036
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: AZ  LAC-08076T)
Enumeration Date2023-12-21
Last Update Date2023-12-21
Business Address
INGRAM MALCOLM KERRY DIRTON
2102 W BETHANY HOME RD
PHOENIX, AZ 85015-1935
Phone number: 602-774-4745
Mailing Address
INGRAM MALCOLM KERRY DIRTON
708 S LINDON LN APT 5020A
TEMPE, AZ 85281-3221
Phone number: 864-979-1325
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