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Individual

MIGUEL ANGEL VEGA COSTAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
738 SCHOEN ST APT A, GREEN BAY, WI 54302-3158
(920) 857-4103
Mailing address
738 SCHOEN ST APT A, GREEN BAY, WI 54302-3158
(920) 857-4103

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
V222-5418-5341-03

Other

Enumeration date
03/30/2026
Last updated
03/30/2026
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