Individual
LUIS TELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4536 S FOREST AVE, TEMPE, AZ 85282-6707
(480) 208-2984
Mailing address
4536 S FOREST AVE, TEMPE, AZ 85282
(480) 208-2984
Taxonomy
Speciality
Code
Description
License number
State
281P00000X
Chronic Disease Hospital
Primary
D04912906
AZ
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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