Individual
IMOGENE YVONNE LANDAVAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
6601 EVERHART, STE B3, CORPUS CHRISTI, TX 78413
(361) 854-2440
(361) 854-2477
Mailing address
6601 EVERHART, STE B3, CORPUS CHRISTI, TX 78413
(361) 854-2440
(361) 854-2477
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001208001
—
TX
Enumeration date
10/05/2006
Last updated
07/27/2010
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