Individual
JESSIE GONZALES ORPILLA IX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15936 W MESCAL ST, SURPRISE, AZ 85379-4698
(623) 414-1940
Mailing address
15936 W MESCAL ST, SURPRISE, AZ 85379-4698
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
D05335001
AZ
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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