Individual
LEON VICTOR CHAGOLLA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2751 KINGSFORD DR, TOLEDO, OH 43614-4416
(419) 290-6072
Mailing address
2751 KINGSFORD DR, TOLEDO, OH 43614-4416
(419) 290-6072
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.16947-NA
OH
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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