Individual
MR. ANTHONY DESJARDINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCP
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 773-2412
(928) 214-2757
Mailing address
3490 W CORRAL GATE, FLAGSTAFF, AZ 86001-2585
(413) 313-3030
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
PL082
MA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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