Organization
KINGMAN HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAUNTELLE VIDINHA D.O. (OSTEOPATHIC PHYSICIAN)
(808) 391-6493
Entity
Organization
Contact information
Practice address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-0626
Mailing address
6907 E LAKEVIEW AVE, MESA, AZ 85209-6635
(808) 391-6493
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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