Most Relevant Information
Provider Data
| NPI Number: | 1003549304 |
| Provider Name: | KEVIN BOUDINOT |
| Entity Type: | Individual |
| Taxonomy Code: | 2279C0205X |
| Specialty: | Respiratory Therapist, Registered |
| License Number: | 044405 |
Most Important Dates
| Enumeration Date: | 07/05/2022 |
| Last Updated: | 07/05/2022 |
Provider Practice Location
CORNER OF ROUTES N12 & N7
FORT DEFIANCE
AZ
86504
Practice Location Phone/Fax
| Phone: | 9287298000 |
| Fax: |
Provider Mailing Location
4141 W BRADSHAW CREEK LN
PHOENIX
AZ
850875811
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |