Individual
ROSA 'SUSIE' ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
831 E 30TH ST, TUCSON, AZ 85713-3602
(520) 721-1887
Mailing address
7820 E BROADWAY BLVD STE 100, TUCSON, AZ 85710-3939
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10212
—
AZ
Enumeration date
01/17/2007
Last updated
07/08/2007
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