Individual
ALAN VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3715 N VALDOSTA RD APT 82, VALDOSTA, GA 31602
(229) 412-2663
Mailing address
3715 N VALDOSTA RD APT 82, VALDOSTA, GA 31602-1086
(229) 412-2663
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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