Individual
MR. JOHN DANGCA VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3001 6TH ST, GREAT LAKES, IL 60088
(910) 450-6397
Mailing address
3904 SEDGE ST, ZION, IL 60099-9503
(910) 546-6907
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/12/2007
Last updated
09/19/2012
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