Individual
MIA QUINTANILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W GUADALUPE RD, TEMPE, AZ 85283-3599
(480) 752-8673
Mailing address
500 W GUADALUPE RD, TEMPE, AZ 85283-3599
(480) 752-8673
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN162572
AZ
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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