Individual
BENJALINE MEDLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
642 W CAMINO CURVITAS, SAHUARITA, AZ 85629-8257
(520) 971-9452
Mailing address
994 S HARRISON RD, TUCSON, AZ 85748-6608
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5838617
AZ
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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