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Vinnolia Mcbride

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NPI Number Detailed Information

Provider Information:

Name: Vinnolia Mcbride
Gender: F
Provider License Number If Given: AP7091

NPI Information:

NPI: 1760485783
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 6/15/2017

Provider Business Mailing Address:

Address: PO BOX 10097
Casa Grande, AZ 85130
Phone Number: (520) 836-3446
Fax Number: 5208368807

Provider Business Practice Location Address:

Address: 1864 E FLORENCE BLVD STE 2
Casa Grande, AZ 85122
Phone Number: 5203810380
Fax Number: 5208361826

Provider Taxonomy:

Primary: 363LW0102X
Secondary (if any):
State: AZ

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