Individual
JESSIE GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1253 MAKALAPA GATE RD BLDG 1407, JBPHH, HI 96860-4479
(518) 653-4308
Mailing address
1253 MAKALAPA GATE RD BLDG 1407, JBPHH, HI 96860-4479
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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