Most Relevant Information
Provider Data
| NPI Number: | 1003454869 |
| Provider Name: | JOHANNA RENEE URQUIJO ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 1354 |
Most Important Dates
| Enumeration Date: | 12/11/2019 |
| Last Updated: | 12/11/2019 |
Provider Practice Location
12775 E MARY ANN CLEVELAND WAY
VAIL
AZ
856418600
Practice Location Phone/Fax
| Phone: | 5206028266 |
| Fax: |
Provider Mailing Location
6282 S TRUTH PL
TUCSON
AZ
857466282
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |