Individual
JEFFREY LEE RIDOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3393 E MORENCI RD, SAN TAN VALLEY, AZ 85143-5979
(480) 415-9949
Mailing address
3393 E MORENCI RD, SAN TAN VALLEY, AZ 85143-5979
(480) 415-9949
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
04/06/2019
Last updated
04/06/2019
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