Individual
OCTAVIANA G CORTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
352 E CAMELBACK RD, SUITE 102, PHOENIX, AZ 85012-1646
(602) 277-5006
(602) 277-5042
Mailing address
214 W 1ST ST, NOGALES, AZ 85621-1622
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
279245
AZ
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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