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1295116440
GABRIEL JACOB BAZURTO
TUCSON, AZ
NPI
1295116440
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ LISAC-11077)
Enumeration Date
2015-06-13
Last Update Date
2015-06-13
Business Address
Mr. GABRIEL JACOB BAZURTO LISAC
2700 S 8TH AVE
TUCSON, AZ 85713-4730
Phone number: 520-628-3400
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Mailing Address
Mr. GABRIEL JACOB BAZURTO LISAC
2700 S 8TH AVE
TUCSON, AZ 85713-4730
Phone number: 520-628-3400
Copy
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