MR. Edgar De La Fuente, LICENSED PROSTHETIST

NPI #1750323713 in Longview, Texas

Provider Information

NPI Number
1750323713
Entity Type
Individual
Name
MR. Edgar De La Fuente, LICENSED PROSTHETIST
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Prosthetic/Orthotic Supplier
Credential
LICENSED PROSTHETIST
Enumeration Date
Jun 12, 2006
Last Updated
Mar 18, 2015

Practice Location

Address
719 N. SECOND STREET
State
Texas
ZIP Code
75601-5316
Phone
(903) 553-1040

Specialties & Taxonomy Codes

Specialty
Prosthetic/Orthotic Supplier

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