Individual
JEROME PADILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 1/2 MILES WEST OF RED ROCK TRADING, RED VALLEY, AZ 86544-4540
(505) 635-4456
(505) 564-2550
Mailing address
PO BOX 454, RED VALLEY, AZ 86544-0454
(505) 635-4456
(505) 564-2550
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
808774
AZ
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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