Individual
MARIO MUNOZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 AUDREY CT, DYER, IN 46311
(708) 601-3268
Mailing address
515 AUDREY CT, DYER, IN 46311-1433
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
057.001465
IL
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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