Individual
CHRISTINA DIANE SANMIGUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3650 W RIDGE RD LOT 112, GARY, IN 46408-1879
(219) 413-6518
Mailing address
3650 W RIDGE RD LOT 112, GARY, IN 46408-1879
(219) 413-6518
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
2360195117
IN
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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