Individual
MR. LUIS SANTIAGO ESCOBAR ACEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 625-4031
Mailing address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11704
MN
Other
Enumeration date
12/18/2014
Last updated
10/24/2024
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