Individual
JON PAUL FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
221 3RD ST W, RANDOLPH AFB, TX 78150-4800
(210) 652-1818
Mailing address
221 3RD ST W, RANDOLPH AFB, TX 78150-4800
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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