Individual
LEWIS ALLEN ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
40444 CHIP CT, PALMDALE, CA 93551-2654
(661) 524-3735
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
30251
CA
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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