Individual
THERESA M MCENTEE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
108 ARIZONA ST, BISBEE, AZ 85603-1804
(520) 432-1145
(520) 432-1217
Mailing address
310 ARIZONA ST, BISBEE, AZ 85603-1502
(520) 432-1145
(520) 432-1217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26574
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432592
—
AZ
Enumeration date
09/26/2005
Last updated
07/08/2007
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