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Individual

MR. RITHIRAT JOHN MCCOLLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
255 WEST BROWN RD., MESA, AZ 85201
(480) 833-3988
Mailing address
16236 W. TONTO ST., GOODYEAR, AZ 85338
(602) 829-7118

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3539
AZ

Other

Enumeration date
09/07/2012
Last updated
09/07/2012
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