Individual
TAMBOURA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3170 S THREE D CT, TUCSON, AZ 85713-6360
(520) 331-7609
Mailing address
3170 S THREE D CT, TUCSON, AZ 85713-6360
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
BH5855
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5855
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
11/19/2019
Last updated
11/19/2019
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