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Individual

GILBERT PANGULAYAN BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
222 PIEDMONT AVE, SUITE 5200, CINCINNATI, OH 45219-4231
(513) 475-7363
Mailing address
2484 BYERS RIDGE DRIVE, MIAMISBURG, OH 45342
(425) 791-0213

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN157482
OH

Other

Enumeration date
09/18/2015
Last updated
09/18/2015
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