Individual
JOHNNY VEGA MERCHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16330 S DELGADO RD, SAHUARITA, AZ 85629-8378
(520) 625-7616
Mailing address
16330 S DELGADO RD, SAHUARITA, AZ 85629-8378
(520) 625-7616
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
12286
AZ
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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