Individual
TREVOR OCTAVIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(724) 961-3349
Mailing address
625 W 1ST ST APT 243, TEMPE, AZ 85281-8233
(724) 961-3349
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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