Organization
PONDEROSA FIRE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSA KELLEY (OFFICE ADMINISTRATOR)
(928) 773-8933
Entity
Organization
Contact information
Practice address
11951 W. SHADOW MOUNTAIN DRIVE, BELLEMONT, AZ 86015
(928) 773-8933
Mailing address
PO BOX 16359, BELLEMONT, AZ 86015-6359
(928) 773-8933
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
—
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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