Individual
MARILOU REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2585 MIRACLE MILE, SUITE 126, BULLHEAD CITY, AZ 86442-7522
(928) 763-7020
(928) 763-7050
Mailing address
PO BOX 23245, BULLHEAD CITY, AZ 86439-3245
(928) 763-7020
(928) 763-7050
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28997
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
787434
—
AZ
Enumeration date
09/09/2005
Last updated
01/06/2014
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