NPI 1659870277

Rocky Ray Deswood

Practitioner Technician Polacca, AZ

Practice location

Address: Hwy 264 Mile Post 388, Polacca, AZ 86042-4000
Phone: (928) 737-6232
Mailing address: PO Box 4000, Polacca, AZ 86042-4000

Registered specialties

Technician Primary

Nursing Service Related Providers Taxonomy 374700000X Licence 891542 (AZ)

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Registry record

NPI: 1659870277
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Feb 2018
Record last updated: 9 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.