Individual
IVAN GRACIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SURGICAL ASSISTANT
Contact information
Practice address
2911 S 8TH AVE, YUMA, AZ 85364-8000
(928) 783-3050
(928) 783-3050
Mailing address
2911 S 8TH AVE, YUMA, AZ 85364-8000
(928) 783-3050
(928) 783-3050
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
R16-0201A
AZ
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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