Individual
MR. JOHN DANIEL GONZALES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5300
Mailing address
PO BOX 1467, COLUMBIA, SC 29202-1467
(803) 765-1838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3896
SC
Other
Enumeration date
04/03/2009
Last updated
06/01/2009
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