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General NPI Number Information
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NPI Number | 1477237949
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Entity Type | Organization
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Legal Business Name | RONIN MEDICAL CONSULTANTS, PLLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 10238 E HAMPTON AVE STE 501
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City | MESA
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State | AZ
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Zip | 85209-3321
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Country | US
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Telephone | 480-889-1573
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Fax |
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Provider Business Mailing Address
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Address Line | 7314 E MADERO AVE
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City | MESA
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State | AZ
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Zip | 85209-4957
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Country | US
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Telephone | 540-353-1887
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE RENEE DAVIDSON
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Credential | RPA-C
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Telephone | 602-727-7227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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