Individual
MR. JOSE R MUNIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3061 OAKCLIFF RD, 149, DORAVILLE, GA 30340
(770) 234-0023
Mailing address
3061 OAKCLIFF RD., APT149, DORAVILLE, GA 30340
(770) 234-0023
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN079003
GA
Other
Enumeration date
02/20/2009
Last updated
02/20/2009
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