Individual
LUIS MANUEL ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
576 JEFFERSON AVE, MCDONALD ARMY HEALTH CENTER, FORT EUSTIS, VA 23604-5548
(757) 314-7522
(757) 314-7524
Mailing address
111 SUMMEGLEN RIDGE, NEWPORT NEWS, VA 23602-8319
(757) 249-8252
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002048061
VA
Other
Enumeration date
10/19/2005
Last updated
01/30/2013
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