Individual
MR. TROY LEON LOMAVAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
HIGHWAY 264, MILEPOST 388, POLACCA, AZ 86042
(928) 737-6000
(928) 737-6055
Mailing address
HIGHWAY 264, MILEPOST 388, POLACCA, AZ 86042
(928) 737-6000
(928) 737-6055
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
542155229
—
AZ
Enumeration date
07/22/2021
Last updated
07/22/2021
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