Individual
JESUS CORONADO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
6821 W TUMBLING T, TUCSON, AZ 85757-9507
(520) 461-5051
Mailing address
6821 W TUMBLING T, TUCSON, AZ 85757-9507
(520) 461-5051
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP034712
AZ
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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