Individual
LELA DAGMAR CANTUALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
167 NORTH MAIN SREET, TUBA CITY, AZ 86045
(928) 283-2781
(928) 283-2677
Mailing address
PO BOX 600, TUBA CITY, AZ 86045
(928) 283-2501
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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