Individual
TODD L MOUTREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, SFA, SA-C
Contact information
Practice address
2424 N. WYATT DR., TUCSON, AZ 85712-6118
(520) 784-6200
(520) 784-6109
Mailing address
PO BOX 31630, TUCSON, AZ 85751-1630
(520) 784-6200
(520) 784-6109
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
99-197
CO
246ZS0410X
Surgical Technologist
99-197
AZ
Other
Enumeration date
07/31/2008
Last updated
03/10/2011
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