Individual
STAR IULI JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10718 E ARBOR AVE, MESA, AZ 85208-8743
(619) 669-8812
Mailing address
10718 E ARBOR AVE, MESA, AZ 85208-8743
(619) 669-8812
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
M79404722
AZ
343900000X
Non-emergency Medical Transport (VAN)
Primary
M79404722
AZ
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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