Individual
JOSE DAVOD PICART III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11582 C STREET, JOINT BASE LEWIS-MCCHORD, WA 98433
(253) 966-7572
Mailing address
1868 MILLER DR, DUPONT, WA 98327-9038
(253) 444-8690
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
162709
TX
Other
Enumeration date
04/29/2016
Last updated
04/29/2016
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