Provider Demographics
NPI:1487982807
Name:GONZALEZ, RAMON JR (LAC)
Entity type:Individual
Prefix:MR
First Name:RAMON
Middle Name:
Last Name:GONZALEZ
Suffix:JR
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1271
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-1271
Mailing Address - Country:US
Mailing Address - Phone:907-224-8777
Mailing Address - Fax:
Practice Address - Street 1:FOURTH STREET
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-1271
Practice Address - Country:US
Practice Address - Phone:907-224-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK21171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist