Individual
MR. DANIEL MATULAC BADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
167 NORTH MAIN ST., TUBA, AZ 86045
(928) 283-2501
Mailing address
167 NORTH MAIN ST., TUBA CITY, AZ 86045
(928) 283-2501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001234638
VA
163W00000X
Registered Nurse
Primary
777420
TX
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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