Individual
MR. ALFRED GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1733 VINE ST, DENVER, CO 80206-1119
(303) 504-1030
Mailing address
1733 VINE ST, DENVER, CO 80206-1119
(303) 504-1030
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30716
CO
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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