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Individual

MR. PRINCE MABIALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2575 N COUNTRY CLUB RD APT A4, TUCSON, AZ 85716-2501
(520) 808-3775
(520) 748-2355
Mailing address
2575 N COUNTRY CLUB RD APT A4, TUCSON, AZ 85716-2501
(520) 808-3775
(520) 748-2355

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
AZ
347C00000X
Private Vehicle
APF8708
AZ
347C00000X
Private Vehicle
Primary
ATN9038
AZ
347C00000X
Private Vehicle
AVF9340
AZ

Other

Enumeration date
04/04/2012
Last updated
04/04/2012
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