Individual
JOSE ANTONIO PESQUEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 E BAFFERT DR APT W101, NOGALES, AZ 85621-4210
(520) 980-2320
Mailing address
994 S HARRISON RD, TUCSON, AZ 85748-6608
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
7784629
AZ
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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