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1700896149
RICHARD M KOOTMAN
PEORIA, AZ
NPI
1700896149
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: AZ 19610)
Enumeration Date
2006-08-08
Last Update Date
2007-12-05
Business Address
Dr. RICHARD M KOOTMAN M.D., P.C.
13943 N 91ST AVE BLDG G
PEORIA, AZ 85381-3687
Phone number: 623-561-1995
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Mailing Address
Dr. RICHARD M KOOTMAN M.D., P.C.
13943 N 91ST AVE BLDG G
PEORIA, AZ 85381-3687
Phone number: 623-561-1995
Copy
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