Individual
OMAR SAUCEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT/HEALTHCARE SPC
Contact information
Practice address
LYSTER ARMY HEALTH CLINIC, BLDG 301 ANDREWS AVE, FORT RUCKER, AL 36362
(334) 255-7894
(334) 255-7490
Mailing address
LYSTER ARMY HEALTH CLINIC, BLDG 301 ANDREWS AVE, FORT RUCKER, AL 36362
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
B1648501
TX
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
04/01/2008
Last updated
04/01/2008
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