Individual
MARIO LUQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA-FA
Contact information
Practice address
3078 CLAIRMONT RD NE APT 522, ATLANTA, GA 30329-1666
(404) 668-6112
Mailing address
3078 CLAIRMONT RD NE APT 522, ATLANTA, GA 30329-1666
(404) 668-6112
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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