Individual
KEVIN BOUDINOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
CORNER OF ROUTES N12 & N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
4141 W BRADSHAW CREEK LN, PHOENIX, AZ 85087-5811
Taxonomy
Speciality
Code
Description
License number
State
2279C0205X
Critical Care Registered Respiratory Therapist
Primary
044405
AZ
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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