Individual
VIOLET TSOSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HC 58 BOX 70, GANADO, AZ 86505-9708
(928) 890-9474
Mailing address
HC58 BOX 70 UNIT 178, GANADO, AZ 86505
(928) 890-9474
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
650556
AZ
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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