Individual
TROY CONSTANT AVENDANIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 W LIBERTY ST, DEPT. OF RADIOLOGY, FARMINGTON, MO 63640-1921
(573) 760-8075
Mailing address
PO BOX 629, FARMINGTON, MO 63640-0629
(573) 760-8075
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L3563
TX
Other
Enumeration date
08/01/2006
Last updated
11/26/2007
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