Individual
THEODORE ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4285 INDIANTOWN RD, SAGINAW, MI 48601-9627
(210) 260-3848
Mailing address
4285 INDIANTOWN RD, SAGINAW, MI 48601-9627
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703117050
MI
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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