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Individual

ALBERT ANTHONY URQUIDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SFIDC

Contact information

Practice address
6769 W LOUISE DR, GLENDALE, AZ 85310-5209
(623) 302-0507
Mailing address
6769 W LOUISE DR, GLENDALE, AZ 85310-5209
(623) 302-0507

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
04/22/2017
Last updated
04/22/2017
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