Individual
MR. JON FRANKLIN SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1617 RIVER BEND TER APT 9, GREEN BAY, WI 54311-4203
(920) 784-9944
Mailing address
1617 RIVER BEND TER APT 9, GREEN BAY, WI 54311-4203
(920) 784-9944
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S53142667140-01
WI
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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