MICHAEL FOSSUM

MESA, AZ
NPI1790991958
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy111NR0400X 
(Licence: AZ  7027)
Enumeration Date2007-05-15
Last Update Date2007-07-08
Business Address
Dr. MICHAEL FOSSUM
1830 S ALMA SCHOOL RD STE 116
MESA, AZ 85210-3086
Phone number: 480-222-5169
Mailing Address
Dr. MICHAEL FOSSUM
1252 N SANTA ANNA ST
CHANDLER, AZ 85224-8592
Phone number: