Individual
ERNESTO CANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2744 W CALLE MORADO, TUCSON, AZ 85745-2522
(520) 721-1887
Mailing address
2744 W CALLE MORADO, TUCSON, AZ 85745-2522
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1128333
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1128333
PROFESSIONAL FOSTER CARE
AZ
Enumeration date
09/04/2008
Last updated
09/04/2008
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