Individual
MARIETTA SCOTT COIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
167 NORTH MAIN ST, TUBA CITY, AZ 86045
(928) 283-2567
Mailing address
PO BOX 600, TUBACITY, AZ 86045
(928) 283-2567
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP013221
AZ
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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