ERICH A WIDEMARK

GOODYEAR, AZ
NPI1669468260
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AZ  083736)
Enumeration Date2005-09-20
Last Update Date2009-11-19
Business Address
-- ERICH A WIDEMARK PhD, FNP-BC
14415 W MCDOWELL RD GOODYEAR
GOODYEAR, AZ 85395-2521
Phone number: 623-512-4190
Mailing Address
-- ERICH A WIDEMARK PhD, FNP-BC
14415 W MCDOWELL RD SUITE D2
GOODYEAR, AZ 85395-2521
Phone number: 623-512-4190
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