Individual
JESUS OCTAVIO AMADOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
2305 SAXONY DR, MOUNT LAUREL, NJ 08054-6806
(310) 856-9968
Mailing address
2305 SAXONY DR, MOUNT LAUREL, NJ 08054-6806
(310) 856-9968
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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