Individual
EDWARD HENRY MIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
251 LLEWELLYN AVE, CAMPBELL, CA 95008-1940
(408) 379-3790
Mailing address
1760 WILLOW LAKE LN, SAN JOSE, CA 95131-3544
(408) 890-9681
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
703373
CA
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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