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Individual

LUIS BLANCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
695 KINKAID RD, ANNAPOLIS, MD 21402-1006
(281) 704-6905
Mailing address
66 REGATTA BAY CT APT 401, ANNAPOLIS, MD 21401-6277

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary

Other

Enumeration date
11/07/2024
Last updated
11/07/2024
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