Organization
INTERNATIONAL HEALTH PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY CRISOSTOMO (CLINIC ADMINISTRATOR)
(671) 929-6214
Entity
Organization
Contact information
Practice address
655 HARMON LOOP RD, SUITE 108, DEDEDO, GU 96929-6544
(671) 929-6214
Mailing address
655 HARMON LOOP RD, SUITE 108, DEDEDO, GU 96929-6544
(671) 929-6214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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