NICHOLAS OTAZO

CAMP LEJEUNE, NC
NPI1649826652
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2019-08-15
Last Update Date2019-08-15
Business Address
NICHOLAS OTAZO
3RD MRB 20073
CAMP LEJEUNE, NC 28546
Phone number: 470-509-0705
Mailing Address
NICHOLAS OTAZO
1060 HENRYS HL
GREENSBORO, GA 30642-5209
Phone number:
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