Individual
JOSE EDWIN AVILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5955 ZEAMER AVE, ELMENDORF AFB, AK 99506-3702
(509) 715-8291
Mailing address
5955 ZEAMER AVE, ELMENDORF AFB, AK 99506-3702
(509) 715-8291
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
03/16/2023
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