Individual
JOHN GONZALES IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
H.I.S.
Contact information
Practice address
1902 W 19TH ST, SUITE A, MOUNTAIN GROVE, MO 65711-1287
(417) 631-2522
Mailing address
4307 FAIR HAVEN DR, NIXA, MO 65714-7339
(417) 631-2522
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2010035283
MO
Other
Enumeration date
03/12/2011
Last updated
03/07/2014
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