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1578778668
BRIAN SHUPLA
TUBA CITY, AZ
NPI
1578778668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2471C3402X Radiologic Technologist, Radiography
(Licence: AZ crt - 11531)
Enumeration Date
2007-05-11
Last Update Date
2007-07-08
Business Address
-- BRIAN SHUPLA R.T. (R)
167 NORTH MAIN STREET
TUBA CITY, AZ 86045
Phone number: 928-283-2702
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Mailing Address
-- BRIAN SHUPLA R.T. (R)
167 NORTH MAIN STREET
TUBA CITY, AZ 86045
Phone number: 928-283-2702
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