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Individual
DIEGO PUENTEZ
Active
Individual
DIEGO PUENTEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
057.000381
IL
314000000X
Skilled Nursing Facility
Primary
057.000381
IL
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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