Edgardo Andres Soto Ramirez
Student in an Organized Health Care Education/Training Program in Springfield, MO. Individual provider (NPI-1).
NPI number1164046017
StatusActive
Last updated in NPPESJun 5, 2020
Details
- NPI
- 1164046017
- Entity type
- Individual (NPI-1)
- Name
- Edgardo Andres Soto Ramirez
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2020
- Certification date
- Jun 5, 2020
- Last updated
- Jun 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
901 S National Ave # Prof160Springfield, MO 65897-0027
Phone 417-836-8553 · Fax 417-836-8554
Mailing address
901 S National Ave # Prof160Springfield, MO 65897-0001
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