Individual
MR. ROBERTO CARRILLO RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
4200 N PEBBLE CREEK PKWY APT 2090, GOODYEAR, AZ 85395-9032
(216) 973-7794
Mailing address
4200 N PEBBLE CREEK PKWY APT 2090, GOODYEAR, AZ 85395-9032
(216) 973-7794
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1012
AZ
2255A2300X
Athletic Trainer
Primary
AT.003568
OH
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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