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General NPI Number Information
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NPI Number | 1356794150
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Entity Type | Individual
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Provider Name | DAVID RYAN SCHANER
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Gender | Female
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Dates
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Enumeration Date | 07/15/2016
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Last Update Date | 07/15/2016
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Provider Practice Location Address
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Address Line | 12533 W COLDWATER SPRINGS BLVD
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City | AVONDALE
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State | AZ
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Zip | 85323-8320
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Country | US
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Telephone | 623-466-7673
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Fax | 623-399-6041
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Provider Business Mailing Address
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Address Line | 12533 W COLDWATER SPRINGS BLVD
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City | AVONDALE
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State | AZ
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Zip | 85323-8320
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Country | US
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Telephone | 623-466-7673
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Fax | 623-399-6041
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | AL10009H
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License Number State | AZ
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