Individual
MARIO ZAVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
408 N AMSTERDAM CT, VIRGINIA BEACH, VA 23454-4213
(310) 803-2890
Mailing address
408 N AMSTERDAM CT, VIRGINIA BEACH, VA 23454-4213
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/19/2016
Last updated
11/19/2016
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