Individual
ALFREDO AYO BANTUG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
FORT DEFIANCE HOSPITAL, FORT DEFIANCE INDIAN HOSPITAL, FORT DEFIANCE, AZ 86504-3166
(209) 665-5890
Mailing address
3802 SHADY VILLAGE LN, SHAFTER, CA 93263-3166
(209) 665-5890
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
15897
TX
Other
Enumeration date
05/19/2020
Last updated
07/21/2022
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