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Individual

MR. CORY WERITO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
NAVAJO ROUTE 12 MILE MARKER 34-3429, FORT DEFIANCE, AZ 86504-0885
(505) 419-4672
(382) 729-5338
Mailing address
PO BOX 885, FORT DEFIANCE, AZ 86504-0885
(505) 419-4672
(382) 729-5338

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
343900000X
AZ

Other

Enumeration date
07/01/2011
Last updated
07/01/2011
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