Individual provider · NPI-1

Victor De Leon, IDMT

Military Health Care Provider, Independent Duty Medical Technicians · Langley Afb, VA

NPI number1033352117
StatusActive
Last updated in NPPESApr 20, 2009

Details

NPI
1033352117
Entity type
Individual (NPI-1)
Name
Victor De Leon
Credential
IDMT
Sex
Male
Sole proprietor
No
Enumeration date
Apr 20, 2009
Last updated
Apr 20, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians––Yes

Practice location

45 Pine St
Langley Afb, VA 23665-2025

Phone 757-764-3869

Mailing address

45 Pine St
Langley Afb, VA 23665-2025

Phone 757-764-3869

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