Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 83-349 | AZ |
NPI | 1003054008 |
---|---|
Provider Name | Dr. Samuel Flagler |
First Address | Tucson, AZ 85715-3910 |
Second Address | Tucson, AZ 85715-3910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2009 |
Last Update Date | 28/01/2009 |