Individual
MISS JULIE ANTONETTE KOOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1990 N CALLE RINCONADO, VAIL, AZ 85641-9328
(520) 286-5707
Mailing address
1990 N CALLE RINCONADO, VAIL, AZ 85641-9328
(520) 286-5707
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27069194A
IN
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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