Individual
FRANK J GONSALVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1670 DEER CREEK DR, SUITE 8, XENIA, OH 45385-8047
(937) 241-3604
Mailing address
1670 DEER CREEK DR, SUITE 8, XENIA, OH 45385-8047
(937) 241-3604
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
130033
OH
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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