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General NPI Number Information
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NPI Number | 1629579172
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Entity Type | Individual
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Provider Name | KATIE JO KROONA OD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 960 W ELLIOT RD STE 106
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City | TEMPE
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State | AZ
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Zip | 85284-1139
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Country | US
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Telephone | 480-491-1078
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Fax |
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Provider Business Mailing Address
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Address Line | 2241 E CAMBRIDGE AVE
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City | PHOENIX
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State | AZ
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Zip | 85006-1321
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Country | US
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Telephone | 320-894-1649
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2235
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License Number State | AZ
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