RAY BOLIVAR

FORT DEFIANCE, AZ
NPI1104195965
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy227800000X Respiratory Therapist, Certified
(Licence: OR  312762)
Enumeration Date2011-12-23
Last Update Date2011-12-23
Business Address
-- RAY BOLIVAR CRT
CORNER OF BIA 12 AND BIA 7
FORT DEFIANCE, AZ 86504
Phone number: 928-129-3366
Mailing Address
-- RAY BOLIVAR CRT
616 S HARDY DR UNIT 203
TEMPE, AZ 85281-7816
Phone number: 928-729-3366