Individual
MR. VICTOR PONDECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9140 E BELLEVUE ST, TUCSON, AZ 85715-5704
(520) 409-3991
Mailing address
9140 E BELLEVUE ST, TUCSON, AZ 85715-5704
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH3300
AZ
Other
Enumeration date
05/21/2009
Last updated
05/27/2009
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