Organization
GIDEON M. ROQUIZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIDEON MANIAGO ROQUIZ (OWNER)
(814) 835-2362
Entity
Organization
Contact information
Practice address
5205 COVENTRY DR, ERIE, PA 16506-6107
(814) 835-2362
Mailing address
5205 COVENTRY DR, ERIE, PA 16506-6107
(814) 835-2362
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
05/30/2008
Last updated
06/03/2008
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