Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 30554 | AZ |
Y | 213ES0000X | Sports Medicine | 30554 | AZ |
NPI | 1093273526 |
---|---|
Provider Name | Bridgette Darton |
First Address | Tucson, AZ 85745-2687 |
Second Address | Tucson, AZ 85745-2687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2019 |
Last Update Date | 21/05/2021 |