Individual
CARIE HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2630 W RUMBLE RD, MODESTO, CA 95350-0155
(120) 957-9944
(209) 579-9444
Mailing address
2630 W RUMBLE RD, MODESTO, CA 95350-0155
12095799444112
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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