Individual
CHAD EVAN OLBERDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
17854 N 31ST ST, PHOENIX, AZ 85032-1118
(602) 909-6858
Mailing address
17854 N 31ST ST, PHOENIX, AZ 85032-1118
(602) 909-6858
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT-01875
AZ
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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