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1871988980
TY NIELSON
PHOENIX, AZ
NPI
1871988980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant Medical
Enumeration Date
2015-04-06
Last Update Date
2017-08-21
Business Address
TY NIELSON
4425 E AGAVE RD STE 148
PHOENIX, AZ 85044-0623
Phone number: 480-704-7546
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Mailing Address
TY NIELSON
4425 E AGAVE RD STE 148
PHOENIX, AZ 85044-0623
Phone number:
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