Individual
ANDREW ZAVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
310 W LOSEY ST, 375TH MDG/SGOPG, SCOTT AFB, IL 62225-5250
(618) 256-7129
Mailing address
4883 LIVELY CT UNIT A, SCOTT AFB, IL 62225-6782
(773) 230-6689
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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