Individual
RUDOLFO BRUCE CAMPOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 MCCORMICK CANYON, CLIFTON, AZ 85533
(928) 865-3109
Mailing address
114 MCCORMICK CANYON, CLIFTON, AZ 85533
(928) 865-3109
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
758287
—
AZ
Enumeration date
12/01/2006
Last updated
07/25/2007
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