Individual
MIGUEL ANTONIO MURILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
424 BLOSSOM ST, TERRYTOWN, LA 70056-2766
(504) 418-9993
Mailing address
424 BLOSSOM ST, TERRYTOWN, LA 70056-2766
(504) 418-9993
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/31/2012
Last updated
10/31/2012
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