Individual
JOSE CORTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 E 7TH ST, CENTRALIA, IL 62801-4506
(954) 243-0083
Mailing address
PO BOX 1673, CENTRALIA, IL 62801-9161
(954) 865-7512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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