Individual
JOSE TARANGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
Mailing address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200686770
FIRST STEPS
—
Enumeration date
05/21/2008
Last updated
05/21/2008
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