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1386123305
EDWARD VIDAL
PHOENIX, AZ
NPI
1386123305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ AP11639)
Enumeration Date
2018-08-09
Last Update Date
2018-11-21
Business Address
EDWARD VIDAL FNP
2331 W CARSON RD
PHOENIX, AZ 85041-6408
Phone number: 602-516-2494
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Mailing Address
EDWARD VIDAL FNP
2331 W CARSON RD
PHOENIX, AZ 85041-6408
Phone number:
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