Individual
MISS MARLENE R SAN NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
415 CHALAN SAN ANTONIO, SUITE 111-113, TAMUNING, GU 96913-3620
(671) 648-3350
(671) 647-3546
Mailing address
PO BOX 6578, TAMUNING, GU 96931-6578
(671) 648-3350
(671) 647-3537
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OL027
GU
Other
Enumeration date
03/28/2006
Last updated
02/27/2013
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