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1518792704
KENNETH ORDIZ MUTIA
FORT BLISS, TX
NPI
1518792704
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2024-09-06
Last Update Date
2024-09-06
Business Address
KENNETH ORDIZ MUTIA
18511 HIGHLANDER MEDICS ST
FORT BLISS, TX 79906-5327
Phone number: 915-742-2273
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Mailing Address
KENNETH ORDIZ MUTIA
3747 VALLEYVIEW ST
MOHEGAN LAKE, NY 10547-1034
Phone number: 914-522-6001
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