Individual
RICHARDO GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 MILITARY ST, PORT HURON, MI 48060-5416
(810) 985-5437
Mailing address
5334 GRATIOT AVE, APT A, SAINT CLAIR, MI 48079-1436
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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