Individual
FREDRICK BEDONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042-0207
(928) 737-6000
Mailing address
PO BOX 207, POLACCA, AZ 86042-0207
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN162871
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
09/15/2014
Last updated
09/15/2014
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