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Individual

GERARDO GRIJALVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2714 E 6TH ST, DOUGLAS, AZ 85607
(520) 368-6937
Mailing address
2714 E 6TH ST, DOUGLAS, AZ 85607-3526
(520) 368-6937

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
D00985585
AZ

Other

Enumeration date
08/07/2014
Last updated
08/07/2014
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