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Individual

LUIS HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
331 SIJEN AVE, WHITEMAN AFB, MO 65305-1269
(660) 687-4310
Mailing address
331 SIJEN AVE, WHITEMAN AFB, MO 65305-1269
(660) 687-4310

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
05/13/2009
Last updated
07/22/2015
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