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1649826652
NICHOLAS OTAZO
CAMP LEJEUNE, NC
NPI
1649826652
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2019-08-15
Last Update Date
2019-08-15
Business Address
NICHOLAS OTAZO
3RD MRB 20073
CAMP LEJEUNE, NC 28546
Phone number: 470-509-0705
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Mailing Address
NICHOLAS OTAZO
1060 HENRYS HL
GREENSBORO, GA 30642-5209
Phone number:
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