Individual
MITCHEL CARL FATOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3612 S FRICK AVE, TUCSON, AZ 85730-2705
(520) 955-4383
Mailing address
3612 S FRICK AVE, TUCSON, AZ 85730-2705
(520) 955-4383
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
2187120
AZ
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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