Individual
MARY ROSE VILLEGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 JAMES ST, LODI, NJ 07644-2305
(631) 359-5859
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 659-5859
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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