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1740759257
LUIS R IBARRA
FORT CAMPBELL, KY
NPI
1740759257
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: WA RN00144561)
Enumeration Date
2018-11-14
Last Update Date
2019-01-28
Business Address
Mr. LUIS R IBARRA RN
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8823
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Mailing Address
Mr. LUIS R IBARRA RN
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8823
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