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Individual

MANUELITA LORENA VILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
606 N KANSAS ST, FORT STOCKTON, TX 79735-5014
(432) 290-1733
Mailing address
606 N KANSAS ST, FORT STOCKTON, TX 79735-5014
(432) 290-1733

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
178164
TX

Other

Enumeration date
02/16/2018
Last updated
02/16/2018
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