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1902091986
LUIS E VIDAL
FORT BELVOIR, VA
NPI
1902091986
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110008968)
Enumeration Date
2007-09-12
Last Update Date
2023-08-10
Business Address
LUIS E VIDAL PA
9300 DEWITT LOOP
FORT BELVOIR, VA 22060-5285
Phone number: 571-231-0374
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Mailing Address
LUIS E VIDAL PA
9300 DEWITT LOOP
FORT BELVOIR, VA 22060-5285
Phone number: 571-231-0374
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