Individual
JAMES CUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21148 E MUNOZ ST, QUEEN CREEK, AZ 85142-6765
(805) 206-0924
Mailing address
21148 E MUNOZ ST, QUEEN CREEK, AZ 85142-6765
(805) 206-0924
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E28449690
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
03/06/2017
Last updated
03/06/2017
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