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LISA B FIRESTONE MD, MPH

>> General Practice >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1134102882

Individual Registrant:
 LISA B FIRESTONE MD, MPH
Gender: F
Not Sole Proprietor

Location and contact information for practice:
4175 S ALAMO AVE 355 AMDS DAVIS MONTHAN A F B, AZ 85707-6097 US
Tel: 520-228-2721  Fax: --

Contact information for business:
14336 E MANHEAD LOOKOUT DR  VAIL, AZ 85641-2550 US
Tel: --  Fax: --

Registration Information:
NPI: 1134102882
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208D00000XAllopathic & Osteopathic Physicians
General Practice
IN01054691A

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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