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1639544307
KEANU BEN TOHANNIE
TUBA CITY, AZ
NPI
1639544307
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
376K00000X Nurse's Aide
(Licence: TX E8L6X2B3)
Enumeration Date
2015-12-07
Last Update Date
2016-01-05
Business Address
KEANU BEN TOHANNIE CERTIFIED MEDICAL AS
167 NORTH MAIN STREET
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2094
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Mailing Address
KEANU BEN TOHANNIE CERTIFIED MEDICAL AS
PO BOX 600
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2094
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