DIEGO PUENTEZ

HAMMOND, IN
NPI1194101790
Professional NameDIEGO PUENTEZ
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy314000000X Skilled Nursing Facility
(Licence: IL  057.000381)
Additional Taxonomies172V00000X Community Health Worker
(Licence: IL  057.000381)
Enumeration Date2015-08-05
Last Update Date2015-08-05
Business Address
-- DIEGO PUENTEZ
1117 SUMMER ST
HAMMOND, IN 46320-2141
Phone number: 219-712-3043
Mailing Address
-- DIEGO PUENTEZ
1117 SUMMER ST
HAMMOND, IN 46320-2141
Phone number: