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1760178081
EDGAR AMAVIZCA
PHOENIX, AZ
NPI
1760178081
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-12
Last Update Date
2023-04-12
Business Address
EDGAR AMAVIZCA MD
350 W THOMAS RD
PHOENIX, AZ 85013-4496
Phone number: 602-406-3000
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Mailing Address
EDGAR AMAVIZCA MD
3100 N CENTRAL AVE # 711D
PHOENIX, AZ 85012-2637
Phone number:
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