NPI 1164656088

Andrew Zavala, IDMT

Practitioner Independent Duty Medical Technicians Scott Afb, IL

Practice location

Address: 310 W Losey St 375th Mdg/Sgopg, Scott Afb, IL 62225-5250
Phone: (618) 256-7129
Mailing address: 4883 Lively CT Unit a, Scott Afb, IL 62225-6782

Registered specialties

Independent Duty Medical Technicians Primary

Other Service Providers Taxonomy 1710I1003X

Other Military Health Care Provider providers in Illinois →

Registry record

NPI: 1164656088
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 May 2009
Record last updated: 6 May 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.