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Individual

STEPHEN MEDEIROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
16455 E AVENUE OF THE FOUNTAINS, FOUNTAIN HILLS, AZ 85268-8307
(480) 351-7641
Mailing address
557 W PRINCETON AVE, GILBERT, AZ 85233-3280

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5385
AZ

Other

Enumeration date
10/26/2017
Last updated
10/26/2017
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