CHARLES IDEMUDIA

SURPRISE, AZ
NPI1013636612
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: AZ  LP039775)
Enumeration Date2022-08-25
Last Update Date2022-08-25
Business Address
CHARLES IDEMUDIA
16088 W SOFT WIND DR
SURPRISE, AZ 85387-1668
Phone number: 602-327-6605
Mailing Address
CHARLES IDEMUDIA
16088 W SOFT WIND DR
SURPRISE, AZ 85387-1668
Phone number: 602-327-6605
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