Individual
MR. ELI ELIUD AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-BASIC
Contact information
Practice address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7894
Mailing address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7894
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
B1686365
OK
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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